Compositions for generation of immune tolerance to specific antigens

ABSTRACT

Peptides that specifically bind erythrocytes are described. These are provided as peptidic ligands having sequences that specifically bind, or as antibodies or fragments thereof that provide specific binding, to erythrocytes. The peptides may be prepared as molecular fusions with therapeutic agents, tolerizing antigens, or targeting peptides. Immunotolerance may be created by use of the fusions and choice of an antigen on a substance for which tolerance is desired.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.15/232,713, filed Aug. 9, 2016, which is a continuation of U.S. patentapplication Ser. No. 13/397,202, filed Feb. 15, 2012, which is acontinuation-in-part of U.S. Ser. No. 13/206,034 filed Aug. 9, 2011 thatclaims priority to U.S. provisional patent application Ser. No.61/372,181 filed Aug. 10, 2010, which are hereby incorporated byreference herein.

TECHNICAL FIELD OF THE INVENTION

The Technical Field relates to medical compositions and uses for ligandsor antibodies that bind erythrocytes. Specific uses includeimmunotolerization, drug delivery, and cancer therapies.

BACKGROUND

The rejection of transplanted tissue and autoimmune diseases arepathological conditions that involve an immunorejection of a foreignbiomolecule because of its antigenic nature. Many drugs and clinicalprocesses are involved in suppressing or treating immunorejection.Vaccines take advantage of this process by stimulating an immuneresponse to antigens on pathogenic biomolecules to build up the immunesystem response against proteins or other biomolecules that carry theantigen.

SUMMARY OF THE INVENTION

Tolerogenesis is a process of creating immunological tolerance to asubstance. A patient, either human or non-human, that is treated tocreate tolerance of a substance will have a reduced adapative immuneresponse to the substance. The reduction in an adaptive immune responsecan be measured by analyzing the amounts of circulating antibodiesreactive to the substance, or by analyzing T-cell reactions to thesubstance and tolerizing agent. Compositions and methods fortolerization are provided herein. Many of the embodiments involveadministering a fusion molecule that has a tolerizing antigen combinedwith an erythrocyte binding moiety. The fusion molecule binds toerythrocytes and begins a process of presenting the tolerizing antigento the immune system in a manner that creates tolerance.

Peptides that specifically bind to erythrocytes (also known as red bloodcells) have been discovered. These peptide ligands areerythrocyte-binding moieties that bind specifically to erythrocytes evenin the presence of other factors present in blood. These ligands may beused in a variety of ways. One embodiment involves forming a molecularfusion of the ligand with a therapeutic agent. The ligand binds theerythrocytes in the body and the therapeutic agent is thus attached tothe erythrocytes and circulates with them. Erythrocytes circulate in thebloodstream for prolonged periods of time, about 90 to 120 days in man,and they access many body compartments related to disease, such as tumorvascular beds, and physiology, such as the liver and the spleen. Thesefeatures can be used to make the erythrocyte useful in therapeuticdelivery, for example in prolonging the circulation of a therapeuticagent in the blood.

It has unexpectedly and surprisingly been found that these erythrocyteaffinity ligands, or comparable antibodies, can be used to createimmunotolerance. In this embodiment, a molecular fusion is made thatcomprises a tolerogenic antigen and an erythrocyte affinity ligand. Thefusion is injected or otherwise administered in sufficient amounts untiltolerance is observed. In contrast, prior reports have stated thatimmuno-rejection is created by attaching an antigen to a surface of anerythrocyte.

Embodiments are also directed to treating cancer by embolizing tumors.Many antigens for tumors and/or tumor microvasculature are known.Antibodies may readily be made that specifically bind these antigens.Such tumor-binding ligands are molecularly fused to ligands that binderythrocytes, i.e., antibodies (or fragments thereof) or peptidicligands. These fusions bind at the tumor site and also binderythrocytes, causing blockage of blood supply to the tumor. Theseembodiments and others are described herein.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is a scatter plot of a flow cytometric analysis of erythrocytebinding of ERY1 phage.

FIG. 2 is a photo montage of an affinity pull-down with solublebiotinylated ERY1 peptide: In panel A: streptavidin-HRP Western blot ofeluted sample using the ERY1 and mismatched peptides; In panel B:anti-mouse GYPA Western blot of eluted sample using the ERY1 peptidecompared to whole erythrocyte lysate.

FIG. 3 is a plot of a cell binding panel.

FIG. 4 is a semi logarithmic plot of an intravenous bolus of ERY1-MBPshowing plasma MBP concentration following intravenous administrationand concentration versus time of ERY1-MBP compared to MBP.

FIG. 5 is a semi logarithmic plot of a subcutaneous bolus of ERY1-MBPshowing plasma MBP concentration following subcutaneous administration;concentration versus time for MBP versus ERY1-MBP.

FIG. 6 is a schematic of scFv engineering designs; in panel A: linearrepresentation of scFv domains from N to C terminus; in panel B:architecture of a folded scFv; in panel C: architecture of a folded scFvwith chemically conjugated ERY1 peptides. FIG. 6 includes linkersequence GGGGS (SEQ ID NO:18) that is repeated four times.

FIG. 7 is a montage of bar graphs showing a percentage of cells thathave bacteria bound as determined by flow cytometry; in panel (A)Peptides on the surface of bacteria bind to erythrocytes but not toepithelial 293T or endothelial HUVECs, with the exception of ERY50; inpanel (B) Peptides bind to multiple human samples, but not to mouseblood.

FIG. 8 shows the experimental scheme and results for the molecularfusion of ERY1 and ovalbumin (OVA), wherein the ERY1-OVA fusion bindsthe equatorial periphery of mouse erythrocytes with high affinity; Panel(a) Schematic of conjugation of ERY1 peptide to ovalbumin (OVA),resulting in binding to erythrocyte-surface glycophorin-A; Panel (b)Binding of each OVA conjugate and intermediate, characterized by flowcytometry; black filled histogram, ERY1-OVA; empty histogram, SMCC-OVA;dotted histogram, MIS-OVA; ERY1=erythrocyte-binding peptide WMVLPWLPGTLD(SEQ ID NO:1), MIS=mismatch peptide PLLTVGMDLWPW (SEQ ID NO:2),SMCC=sulfosuccinimidyl-4-(N-maleimidomethyl) cyclohexane-l-carboxylate,used to conjugate ERY1 to OVA; Panel (c) Equilibrium binding of ERY1-OVAto erythrocytes demonstrating the low dissociation constant of ERY1-OVA(R²=0.97, one-site binding), determined by flow cytometry.

FIG. 9 shows the experimental scheme and results for the binding andcirculation of the molecular fusion of ERY1-conjugated antigen: thefusion biospecifically binds circulating healthy and eryptoticerythrocytes upon intravenous administration, inducing uptake byspecific antigen presenting cell subsets; Panel (a) OVA (grey filledhistogram) and ERY1-OVA (black filled histogram) binding to erythrocyte(CD45⁻) and nonbinding to leukocyte (CD45⁺) populations in vivo ascompared to non-injected mice (empty histogram), determined by flowcytometry; Panel (b) ERY1-OVA binding and OVA nonbinding to circulatingeryptotic (annexin-V⁺) and healthy (annexin-V⁻) erythrocytes, determinedby flow cytometry; Panel (c) Cell surface half-life of bound ERY1-OVA tocirculating erythrocytes, determined by geometric mean fluorescenceintensity of flow cytometry measurements (n=2, R²=0.98, one-phaseexponential decay); Panel (d) Time-dependent ERY1-OVA cell-surfaceconcentration, determined by ELISA, at an administered dose of 150 μg(n=2).

FIG. 10 is a montage of plots showing that erythrocyte binding does notalter hematological behavior; Panel (a) Hematocrit; Panel (b) meancorpuscular volume, and Panel (c) erythrocyte hemoglobin contentmeasured at varying time points following administration of either 10 μgOVA (open circles) or ERY1-OVA (closed circles).

FIG. 11 is a bar graph of results wherein an ERY1-conjugated antigenbiospecifically induces uptake by specific antigen presenting cellsubsets: Panel (a) Increased cellular uptake of ERY1-allophycocyanin byMHCII⁺ CD11b⁻ CD11c⁺ and MHCII⁺ CD8α⁺ CD11c⁺ CD205⁺ splenic dendriticcells (DCs) at 12 and 36 h post-injection, as compared withMIS-allophycocyanin; Panel (b) Increased cellular uptake ofERY1-allophycocyanin in the liver by hepatocytes (CD45⁻ MHCII⁻ CD1d⁻)and hepatic stellate cells (CD45⁻ MHCII⁺ CD1d⁺), but not liver DCs(CD45⁺ CD11c⁺) or Kupffer (CD45⁺ MHCII⁺ F4/80⁺) cells, as compared withMIS-allophycocyanin, 36 h following intravenous administration. (n=2,*P≤0.05, **P≤0.01, ***P≤0.001). Data represent mean±SE.

FIG. 12 is a montage of results showing that a molecular fusion ofERY1-OVA enhances cross-priming and apoptotic-fate deletionalproliferation of antigen-specific OTI CD8⁺ T cells in vivo: Panel (a)Proliferation of carboxyfluorescein succinimidyl ester (CFSE)-labeledsplenic OTI CD8⁺ T cells (CD3ε⁺ CD8α⁺ CD45.2⁺) 5 d following intravenousadministration of 10 μg ERY1-glutathione-S-transferase (ERY1-GST, leftpanel), 10 μg OVA (middle panel), or 10 μg ERY1-OVA (right panel); Panel(b) Dose-dependent quantified proliferative populations of OTI CD8⁺ Tcell proliferation from A, as well as an identical 1 μg dosing study,data represent median±min to max (n=5, **P≤0.01, ^(##)P<0.01); Panel (c)OTI CD8⁺ T cell proliferation generations exhibiting larger annexin-V⁺populations upon ERY1-OVA administration (right panel), as compared withOVA (middle panel) or ERY1-GST (left panel); Panel (d) Quantifiedannexin-V⁺ OTI CD8⁺ T cell proliferation generations demonstratingERY1-OVA induced OTI CD8⁺ T cell apoptosis, data represent mean±SE (n=5,***P<0.0001). All data determined by multi-parameter flow cytometry.

FIG. 13 is a montage of results presented as bar graphs showing that amolecular fusion of ERY1-OVA induces OTI CD8⁺ T cell proliferation to anantigen-experienced phenotype; Panel (a) Quantification of CD44⁺ OTICD8⁺ T cells (CD3ε⁺ CD8α⁺ CD45.2⁺ CD44⁺) in the spleen 5 d followingadministration of 1 μg OVA or 1 μg ERY1-OVA, (***P<0.0001); Panel (b)Quantification of CD62L⁻ OTI CD8⁺ T cells (CDR⁺ CD8α⁺ CD45.2⁺ CD62L⁻ inthe spleen 5 d following administration of 1 μg OVA or 1 μg ERY1-OVA,(*P<0.05); Panel (c) Quantification of CD44⁺ OTI CD8⁺ T cells (CDR⁺CD8α⁺ CD45.2⁺ CD44⁺) in the spleen 5 d following administration of 10 μgOVA or 10 μg ERY1-OVA, (***P=0.0005); Panel (d) Quantification of CD62L⁻OTI CD8⁺ T cells (CD3ε⁺ CD8α⁺ CD45.2⁺ CD62L⁻ in the spleen 5 d followingadministration of 10 μg OVA or 10 μg ERY1-OVA, (***P<0.0001). Datarepresent mean±SE, n=5.

FIG. 14 is a montage of results showing that erythrocyte-binding inducestolerance to antigen challenge: Panel (a) The OTI CD8⁺ T cell adoptivetransfer tolerance model, displaying experimental protocol forexperimental as well as challenge and naive control groups (n=5); Panel(b) Flow cytometric detection of OTI CD8⁺ T cell populations (CDR⁺ CD8α⁺CD45.2⁺); Panel (c) OTI CD8⁺ T cell population quantification in thedraining lymph nodes (inguinal and popliteal) 4 d following antigenchallenge in CD45.1⁺ mice (**P<0.01); Panel (d) Flow cytometricdetection of IFNγ-expressing OTI CD8⁺ T cells; Panel (e) IFNγ-expressingOTI CD8⁺ T cells in the draining lymph nodes 4 d following antigenchallenge and restimulation with SIINFEKL peptide (SEQ ID NO:3)(**P<0.01); Panel (f) IFNγ concentrations in lymph node cell culturemedia 4 d following restimulation with SIINFEKL peptide (SEQ ID NO:3),determined by ELISA (**P<0.01); Panel (g) IL-10 concentrations in lymphnode cell culture media 4 d following restimulation with OVA, determinedby ELISA (*P<0.05). Data represent median±min to max; Panel (h)OVA-specific serum IgG titers at day 19, (*P<0.05) data representmean±SE; Panel (i) The combination OTI and OVA-expressing EL4 thymoma(E.G7-OVA) tumor tolerance model, displaying experimental protocol forexperimental as well as control groups (n=4, 3, respectively); Panel (j)Quantification of non-proliferating (generation 0) OTI CD8⁺ T cellscirculating in blood 5 d following adoptive transfer; data representmedian±min to max (**P<0.01); Panel (k) Growth profile of E.G7-OVAtumors, subcutaneously injected 9 d following OTI adoptive transfer,data represent mean±SE (*P<0.05).

FIG. 15 is a bar graph showing how erythrocyte binding attenuatesantigen-specific humoral responses in C57BL/6 mice. OVA-specific IgGdetection in serum 19 days following two administrations of 1 μg OVA or1 μg ERY1-OVA 6 d apart in C57BL/6 mice (*P≤0.05).

FIG. 16 presents experimental results wherein 8-arm PEG-ERY1 bindserythrocytes in vitro and in vivo; Panel (a) 8-arm PEG-ERY1 (blackfilled histogram), but not 8-arm PEG-MIS (grey filled histogram) or8-arm PEG-pyridyldisulfide bind to mouse erythrocytes following in vitroincubation; Panel (b) 8-arm PEG-ERY1 (black filled histogram), but not8-arm PEG-MIS (grey filled histogram) bind to circulating erythrocytesupon intravenous injection.

FIG. 17 presents experimental results depicting erythrocyte cell-surfacehalf-life of 8-arm PEG-ERY1 (filled circles) and 8-arm PEG-MIS (emptyboxes), determined by flow cytometry.

FIG. 18 presents experimental results as a bar graph showing binding ofpeptidic ligands to human erythrocytes.

FIG. 19 presents experimental results as a flow cytometry histogram.Mouse erythrocytes were incubated with TER119-SIINFEKL (grey filledhistogram) or albumin (empty histogram). Fluorescent signal comes fromthe anti-6× His-PE antibody used in detection of the scFv.

FIG. 20 is a plot of experimental results showing proliferating OT-I CD8T cells in the spleen following intravenous administration of: saline,OVA, ERY1-OVA, or TER119-SIINFEKL. **P<0.01, ***P<0.001

FIG. 21 is a plot of experimental results showing phenotypiccharacterization of OTI CD8 T cells following adoptive transfer andintravenous administration of: saline, OVA, ERY1-OVA, orTER119-SIINFEKL. Left panel: apoptotic OTI cell induction marked byAnnexin-V binding in flow cytometry; Right panel: exhausted OTI cellinduction marked by expression of PD-1 in flow cytometry.

FIG. 22 is a plot of experimental results showing characterization ofinflammatory (IFNγ+) OTI T cells in lymph nodes draining the site ofchallenge from mice tolerized with various injection formulations, asanalyzed by flow cytometry.

FIG. 23 is a plot of experimental results showing asparaginase(ASNase)-specific serum IgG titers from mice receiving 2 or 6 doses ofERY1-ASNase or wild-type ASNase, 21 days following administration, asdetermined by ELISA.

FIG. 24 is a plot of experimental results showing proliferation of CD4 Tcells from the transgenic NODBDC2.5 mouse in co-culture with splenicDCs, with various media additives.

FIG. 25 is a plot of experimental results showing quantification ofnon-proliferating NODBDC2.5 CD4 T cells following adoptive transfer andintravenous administration of TER119-ChrA, free 1040-p31 peptide, orsaline, as determined by flow cytometry.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Molecular designs are provided for tolerogenesis. The protein or othermolecular antigen to which tolerance is sought is formed as a conjugatewith an erythrocyte binding moiety. The moiety may comprise a peptideligand, an antibody, an aptamer, or an antibody fragment. The conjugate,also referred to as a molecular fusion, may be a fusion protein or mayinvolve a linker, e.g., a polymer or polymer micelle or polymernanoparticle conjugate.

Peptides that specifically bind erythrocytes are described herein. Theseare provided as peptidic ligands having sequences that specificallybind, or as antibodies or fragments thereof that provide specificbinding, to erythrocytes. The peptides may be prepared as molecularfusions with therapeutic agents, tolerizing antigens, or targetingpeptides. The therapeutic agents may advantageously have an increasedcirculating half-life in vivo when they are part of the fusion.Immunotolerance may be created by use of the fusions and choice of anantigen on a substance for which tolerance is desired. The term antigen,in this context, means the full size antigen, an antigenic fragmentthereof, or a mimetic of the tolerogenic antigen. Fusions with targetingpeptides direct the fusions to the target, for instance a tumor, wherethe erythrocyte-binding ligands reduce or entirely eliminate blood flowto the tumor by recruiting erythrocytes to the target.

Molecular designs involving erythrocyte binding are thus taught forextending the circulation half life of drugs, including protein drugs.The drug is formed as a conjugate, also referred to as a molecularfusion, for example a recombinant fusion or a chemical conjugate, withthe erythrocyte binding ligand. Molecular designs are also taught fortumor embolization. The erythrocyte binding ligand is formed as aconjugate with a ligand for tumor vasculature; targeting to the tumorvasculature thus targets erythrocyte binding within the tumorvasculature.

Peptidic Sequences that Specifically Bind Erythrocytes

Peptides that specifically bind erythrocytes have been discovered.Example 1 describes the discovery of a peptide (ERY1) for specificallybinding to an erythrocyte. Example 8 describes the discovery of sixpeptides (ERY19, ERY59, ERY64, ERY123, ERY141 and ERY162) that bindspecifically to human erythrocytes. Example 20 details how peptidicligands (ERY64, ERY123, and ERY141) were made part of a fusion proteinwith a fluorescent protein reporter and retained their specific bindingproperties. An embodiment of the invention is a substantially purepolypeptide comprising an amino acid sequence of ERY1, or one of thehuman erythrocyte binding peptides, or a conservative substitutionthereof, or a nucleic acid encoding the same. Such polypeptides bindspecifically erythrocytes and are a ligand for the same. Ligand is aterm that refers to a chemical moiety that has specific binding to atarget molecule. A target refers to a predetermined molecule, tissue, orlocation that the user intends to bind with the ligand. Thus targeteddelivery to a tissue refers to delivering a molecule or other materialsuch as a cell to the intended target tissue. Accordingly, embodimentsinclude molecules or compositions comprising at least one of the ligandsdisclosed herein that are used to bind an erythrocyte. The bindingactivity of a polypeptide to an erythrocyte may be determined simply byfollowing experimental protocols as described herein. Using suchmethods, the binding strengths of polypeptide variants relative to ERY1or a human erythrocyte binding peptide under given physiologicalconditions can be determined, e.g., sequences made using conservativesubstitutions, addition or removal of flanking groups, or changes oradditions for adjusting sequence solubility in aqueous solution.

Peptidic ligands may be generated specifically for one or more of thefollowing targets or group of targets: an erythrocyte surface molecule(protein, glycoprotein), Band 3 (CD233), a glycophorin, moreparticularly glycophorin A (CD235a), glycophorin B (CD235b), glycophorinC (CD235c) & glycophorin D (CD235d), aquaporin-1, Glut-1, Kidd antigen,RhAg/Rh50 (CD241), Rh (CD240), Rh30CE (CD240CE), Rh30D (CD240D), Kx,Kell (CD238), Duffy/DARC (CD234), CR1 (CD35), DAF (CD55), Globoside,CD44, ICAM-4 (CD242), Lu/B-CAM (CD239), XG1/XG2 (CD99),EMMPRIN/neurothelin (CD147), JMH, Glycosyltransferase, Cartwright,Dombrock, C4A/CAB, Scianna, MER2, stomatin, BA-1 (CD24), GPIV (CD36),CD108, CD139, and H antigen (CD173). Erythrocytes cell-surface proteins,either purified preparations or a mixture of them, can be screened forpeptidic ligands. Erythrocyte cell-surface proteins may be recombinantlyexpressed in their full form or as partial domains fused to tags thatenhance expression or stability of the protein. The recombinant proteintarget may then be immobilized on a plate or bead, and used as theaffinity target for the library screening process. Erythrocytecell-surface proteins may also be isolated from cellular preparations ofwhole blood, from which purified or complex mixtures of membraneproteins may be immobilized on a solid matrix (bead, plate, or other),and used as affinity targets for the screening process. The entirescreening process may be performed in the presence of a highconcentration of serum albumin (e.g., 50 mg/mL) and at 37° C. to reducenon-specific binding events and to select for peptides with favorablebinding characteristics in blood serum. Peptidic ligands are mostpreferably selected from Band 3 (CD233), glycophorin B (CD235b),glycophorin C (CD235c) and glycophorin D (CD235d).

As detailed in Example 2, peptidic ligands were observed to bind theerythrocyte cell surfaces without altering cell morphology and withoutcytoplasmic translocation. The ligands distributed across the cellsurface and were free of clustering. Specific proteins that were thetarget of the ligands can be identified, as in Example 3, whichidentified glycophorin-A (GYPA) as the target of ERY-1. ERY-1 wasreactive only with mouse and rat species (Example 4). Peptidic ligandsthat specifically bound human erythrocytes were specific for humanerythrocytes and not other species (Example 9).

A naïve peptide library involving whole erythrocytes was screened todiscover affinity partners, rather than screening against a purifiederythrocyte cell-surface protein. Through the use of density gradientcentrifugation and extensive washing, meticulous care was taken tominimize the number of unbound phage escaping round elimination.Furthermore, selection was halted and clones were analyzed early in thescreening process so as to prohibit highly infective phage clones fromdominating the population. The entire screening process was performed inthe presence of a high concentration of serum albumin (50 mg/mL) and at37° C. to reduce non-specific binding events and, perhaps moreimportantly, select for peptides with favorable binding characteristicsin blood serum. In a first set of experiments (Example 1) clonalanalysis revealed one phage clone displaying a high-affinity peptide,WMVLPWLPGTLD (SEQ ID NO:1 herein termed ERY1), towards the mouseerythrocyte cell surface (FIG. 1). When similarity searched using theBLAST algorithm in UniProt, no relevant protein sequence homology wasidentified towards the full peptide. Other experiments (Example 8)identified binding ligands for human erythrocytes as shown in Tables1-2. Six sequences bound specifically to human erythrocytes. A seventhsequence, named ERY50, bound human erythrocytes and also boundepithelial/endothelial cells.

TABLE 1 Peptidic ligands that bind human erythrocytes PeptideHuman Erythrocyte Binding Sequence Name Peptide Sequence IdentifierERY19 GQSGQ PNSRWIYMTPLSPGIYR GSSGGS SEQ ID NO: 4 ERY50 GQSGQSWSRAILPLFKIQPV GSSGGS SEQ ID NO: 5 ERY59 GQSGQ YICTSAGFGEYCFID GSSGGSSEQ ID NO: 6 ERY64 GQSGQ TYFCTPTLLGQYCSV GSSGGS SEQ ID NO: 7 ERY123 GQSGHWHCQGPFANWV GSSGGS SEQ ID NO: 8 ERY141 GQSGQ FCTVIYNTYTCVPSS GSSGGSSEQ ID NO: 9 ERY162 GQSGQ SVWYSSRGNPLRCTG GSSGGS SEQ ID NO: 10Underlined sequence portions indicate linker sequences

TABLE 2 Peptidic ligands that bind mouse or human erythrocytes SequencePeptide Identifier ERY19′ PNSRWIYMTPLSPGIYR SEQ ID NO: 11 ERY50′*SWSRAILPLFKIQPV SEQ ID NO: 12 ERY59′ YICTSAGFGEYCFID SEQ ID NO: 13ERY64′ TYFCTPTLLGQYCSV SEQ ID NO: 14 ERY123′ HWHCQGPFANWV SEQ ID NO: 15ERY141′ FCTVIYNTYTCVPSS SEQ ID NO: 16 ERY162′ SVWYSSRGNPLRCTGSEQ ID NO: 17 ERY1** WMVLPWLPGTLD SEQ ID NO: 1 *not specific forerythrocytes **for mouse

Embodiments of the invention include peptides that that specificallybind the surface of erythrocytes. The sequences were not optimized forminimum length. Such optimization is within the skill of the art and maybe practiced using techniques described herein. For example, Kenrick etal. (Protein Eng. Des. Sel. (2010) 23(1):9-17) screened from a 15residue library, and then identified minimal binding sequences 7residues in length. Getz (ACS Chem. Biol., May 26, 2011 identifiedminimal binding domains as small as 5 residues in length. Theerythrocyte binding peptides may be present in repeats of the samesequences, e.g., between 2 and 20 repeats; artisans will immediatelyappreciate that all the ranges and values within the explicitly statedranges are contemplated. Moreover, the peptides may be present incombination, with two or more distinct sequences being in the samepeptide or being part of a single molecular fusion.

The number of consecutive residues that provide specific binding isexpected to be between about 4 and 12 residues. Accordingly, allpeptides of four consecutive residues in length found in Table 2 aredisclosed, as well as all peptides of, e.g., 5, 6, 7, or 8 consecutiveresidues. This number is based on the number of residues for otherpeptidic protein-binding ligands. Embodiments of the invention includeminimum length sequences for one of the erythrocyte-binding SEQ IDs setfor the herein, including Table 1. Accordingly, certain embodiments aredirected to a composition comprising a peptide, or an isolated (orpurified) peptide, comprising a number of consecutive amino acidsequences between 4 and 12 consecutive amino acid residues of a sequencechosen from the group consisting of SEQ ID NO:11, SEQ ID NO:13, SEQ IDNO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID NO:17, SEQ ID NO:1, andconservative substitutions thereof, wherein said sequence specificallybinds an erythrocyte. Alternatively the number of consecutive residuesmay be chosen to be between about 5 and about 18; artisans willimmediately appreciate that all the ranges and values within theexplicitly stated ranges are contemplated, e.g., 7, 8, 9, 10, or from 8to 18. The erythrocyte-binding sequence may have, e.g., a conservativesubstitution of at least one and no more than two amino acids of thesequences, or 1, 2, or 3 substitutions, or between 1 and 5substitutions. Moreover, the substitution of L-amino acids in thediscovered sequence with D-amino acids can be frequently accomplished,as in Giordano. The peptide or composition may, in some embodiments,consist essentially of a sequence chosen from the group consisting ofSEQ ID NO:11, SEQ ID NO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16,SEQ ID NO:17, SEQ ID NO:1. The peptide may be limited in length, e.g.,having a number of residues between about 10 and about 100; artisanswill immediately appreciate that all the ranges and values within theexplicitly stated ranges are contemplated, e.g., about 10 to about 50 orabout 15 to about 80. A peptide erythrocyte-binding moiety may beprovided that comprises a peptide ligand that has a dissociationconstant of between about 10 μM and 0.1 nM as determined by equilibriumbinding measurements between the peptide and erythrocytes; artisans willimmediately appreciate that all the ranges and values within theexplicitly stated ranges are contemplated, e.g., from about 1 μM toabout 1 nM. The peptide may further comprise a therapeutic agent. Thetherapeutic agent may be, e.g., a protein, a biologic, an antibodyfragment, an ScFv, or a peptide. The peptide may further comprise atolerogenic antigen, e.g., a human protein used in a human deficient inthat protein (e.g., blood factors such as factor VIII or factor IX),proteins with nonhuman glycosylation, synthetic proteins not naturallyfound in humans, human food allergens, or human autoimmune antigens.

Others have searched for peptidic ligands that specifically bind thesurface of erythrocytes. A prior study attempted the discovery oferythrocyte-binding peptides by use of a novel bacterial surfacedisplayed peptide library screening method (Hall, Mitragotri, et al.,2007). The focus of their study was to establish their novel bacterialpeptide display system to screen naïve libraries for peptides withaffinity for erythrocytes, and use the peptides to attach 0.22 μmparticles to erythrocytes. Though they reported the identification ofseveral peptides that accomplish this task, they did not characterizethe binding phenomena to a sufficient degree required for applicableconsideration. They did not report the cellular binding specificity ofthe peptides; the issue of what other cell types the peptides bind to isnot addressed. Nor did they report the cell surface ligand of thepeptides. Electron micrographs taken of the erythrocytes labeled withpeptide-functionalized 0.22 μm particles depict erythrocytes with singleclusters of particles per cell. Most potential binding sites would beexpected to be broadly distributed over the cell surface and the factthat all of the tested ligands were localized to a small cell areaindicates that these results are an experimental artifact. Such anartifact may be the result of the molar excess at which labeling wasconducted, or other factors. No in vivo characterization ofpeptide-particle erythrocyte binding or pharmacokinetics was conducted.Taken together, the results described by Hall and colleagues do notsuggest that peptide ligands to erythrocytes may be used as tools toimprove the pharmacokinetics of therapeutics or in other medical ortherapeutic fashion.

Polypeptides of various lengths may be used as appropriate for theparticular application. In general, polypeptides that contain thepolypeptide ligand sequences will exhibit specific binding if thepolypeptide is available for interaction with erythrocytes in vivo.Peptides that have the potential to fold can be tested using methodsdescribed herein. Accordingly, certain embodiments are directed topolypeptides that have a polypeptide ligand but do not occur in nature,and certain other embodiments are directed to polypeptides havingparticular lengths, e.g., from 6 to 3000 residues, or 12-1000, or12-100, or 10-50; artisans will immediately appreciate that every valueand range within the explicitly articulated limits is contemplated.

Certain embodiments provide various polypeptide sequences and/orpurified or isolated polypeptides. A polypeptide is a term that refersto a chain of amino acid residues, regardless of post-translationalmodification (e.g., phosphorylation or glycosylation) and/orcomplexation with additional polypeptides, synthesis into multisubunitcomplexes, with nucleic acids and/or carbohydrates, or other molecules.Proteoglycans therefore also are referred to herein as polypeptides. Asused herein, a “functional polypeptide” is a polypeptide that is capableof promoting the indicated function. Polypeptides can be produced by anumber of methods, many of which are well known in the art. For example,polypeptides can be obtained by extraction (e.g., from isolated cells),by expression of a recombinant nucleic acid encoding the polypeptide, orby chemical synthesis. Polypeptides can be produced by, for example,recombinant technology, and expression vectors encoding the polypeptideintroduced into host cells (e.g., by transformation or transfection) forexpression of the encoded polypeptide.

There are a variety of conservative changes that can generally be madeto an amino acid sequence without altering activity. These changes aretermed conservative substitutions or mutations; that is, an amino acidbelonging to a grouping of amino acids having a particular size orcharacteristic can be substituted for another amino acid. Substitutesfor an amino acid sequence may be selected from other members of theclass to which the amino acid belongs. For example, the nonpolar(hydrophobic) amino acids include alanine, leucine, isoleucine, valine,proline, phenylalanine, tryptophan, methionine, and tyrosine. The polarneutral amino acids include glycine, serine, threonine, cysteine,tyrosine, asparagine and glutamine. The positively charged (basic) aminoacids include arginine, lysine and histidine. The negatively charged(acidic) amino acids include aspartic acid and glutamic acid. Suchalterations are not expected to substantially affect apparent molecularweight as determined by polyacrylamide gel electrophoresis orisoelectric point. Conservative substitutions also include substitutingoptical isomers of the sequences for other optical isomers, specificallyD amino acids for L amino acids for one or more residues of a sequence.Moreover, all of the amino acids in a sequence may undergo a D to Lisomer substitution. Exemplary conservative substitutions include, butare not limited to, Lys for Arg and vice versa to maintain a positivecharge; Glu for Asp and vice versa to maintain a negative charge; Serfor Thr so that a free —OH is maintained; and Gln for Asn to maintain afree NH₂. Moreover, point mutations, deletions, and insertions of thepolypeptide sequences or corresponding nucleic acid sequences may insome cases be made without a loss of function of the polypeptide ornucleic acid fragment. Substitutions may include, e.g., 1, 2, 3, or moreresidues. The amino acid residues described herein employ either thesingle letter amino acid designator or the three-letter abbreviation.Abbreviations used herein are in keeping with the standard polypeptidenomenclature, J. Biol. Chem., (1969), 243, 3552-3559. All amino acidresidue sequences are represented herein by formulae with left and rightorientation in the conventional direction of amino-terminus tocarboxy-terminus.

In some cases a determination of the percent identity of a peptide to asequence set forth herein may be required. In such cases, the percentidentity is measured in terms of the number of residues of the peptide,or a portion of the peptide. A polypeptide of, e.g., 90% identity, mayalso be a portion of a larger peptide

The term purified as used herein with reference to a polypeptide refersto a polypeptide that has been chemically synthesized and is thussubstantially uncontaminated by other polypeptides, or has beenseparated or purified from other most cellular components by which it isnaturally accompanied (e.g., other cellular proteins, polynucleotides,or cellular components). An example of a purified polypeptide is onethat is at least 70%, by dry weight, free from the proteins andnaturally occurring organic molecules with which it naturallyassociates. A preparation of a purified polypeptide therefore can be,for example, at least 80%, at least 90%, or at least 99%, by dry weight,the polypeptide. Polypeptides also can be engineered to contain a tagsequence (e.g., a polyhistidine tag, a myc tag, or a FLAG® tag) thatfacilitates the polypeptide to be purified or marked (e.g., capturedonto an affinity matrix, visualized under a microscope). Thus a purifiedcomposition that comprises a polypeptide refers to a purifiedpolypeptide unless otherwise indicated. The term isolated indicates thatthe polypeptides or nucleic acids of the invention are not in theirnatural environment. Isolated products of the invention may thus becontained in a culture supernatant, partially enriched, produced fromheterologous sources, cloned in a vector or formulated with a vehicle,etc.

Polypeptides may include a chemical modification; a term that, in thiscontext, refers to a change in the naturally-occurring chemicalstructure of amino acids. Such modifications may be made to a side chainor a terminus, e.g., changing the amino-terminus or carboxyl terminus.In some embodiments, the modifications are useful for creating chemicalgroups that may conveniently be used to link the polypeptides to othermaterials, or to attach a therapeutic agent.

Specific binding, as that term is commonly used in the biological arts,refers to a molecule that binds to a target with a relatively highaffinity compared to non-target tissues, and generally involves aplurality of non-covalent interactions, such as electrostaticinteractions, van der Waals interactions, hydrogen bonding, and thelike. Specific binding interactions characterize antibody-antigenbinding, enzyme-substrate binding, and specifically bindingprotein-receptor interactions; while such molecules may bind tissuesbesides their targets from time to time, such binding is said to lackspecificity and is not specific binding. The peptide ERY1 and itsderivatives and the human erythrocyte binding peptides and theirderivatives may bind non-erythrocytes in some circumstances but suchbinding has been observed to be non-specific, as evidenced by the muchgreater binding of the peptides to the erythrocytes as opposed to othercells or proteins.

Thus, embodiments include a ligand that binds with specificity to anerythrocyte and does not specifically bind other blood components, e.g.,one or more of: blood proteins, albumin, fibronectin, platelets, whiteblood cells, substantially all components found in a blood sample takenfrom a typical human. In the context of a blood sample, the term“substantially all” refers to components that are typically present butexcludes incidental components in very low concentrations so that theydo not effectively reduce the titer of otherwise bioavailable ligands.

Antibody Peptides

In addition to peptides that bind erythrocytes, proteins are alsopresented herein, specifically antibodies and especially single chainantibody fragments. Techniques for raising an antibody against anantigen are well known. The term antigen, in this context, refers to asite recognized by a host immune system that responds to the antigen.Antigen selection is known in the arts of raising antibodies, amongother arts. Embodiments include use of these peptides in a molecularfusion and other methods presented herein. Antigens may be recombinantlyexpressed in their full form or as partial domains fused to tags thatenhance expression or stability of the protein. The recombinant proteinantigen may then be immobilized on a plate or bead, and used as theaffinity target for the library screening process. Antigens may also beisolated from cellular preparations of whole blood, from which purifiedor complex mixtures of membrane proteins may be immobilized on a solidmatrix (bead, plate, or other), and used as affinity targets for thescreening process.

Artisans reading this disclosure will be able to create antibodies thatspecifically bind erythrocytes. Examples 15-17 relate to makingantibodies or fragments thereof. Numerous parallel techniques are usedto discover new antibodies or antibody fragments or to make compositionscomprising such fragments active towards erythrocytes, including but notlimited to phage display, yeast display, and bacterial display.Additional erythrocyte binding antibodies or antibody fragments, orscFvs may be generated specifically for one or more of the followingtargets or group of targets (collectively referred to herein as theErythrocyte Target Group) chosen from the group consisting of Band 3(CD233), aquaporin-1, Glut-1, Kidd antigen, RhAg/Rh50 (CD241), Rh(CD240), Rh30CE (CD240CE), Rh30D (CD240D), Kx, glycophorin A (CD235a),glycophorin B (CD235b), glycophorin C (CD235c), glycophorin D (CD235d),Kell (CD238), Duffy/DARC (CD234), CR1 (CD35), DAF (CD55), Globoside,CD44, ICAM-4 (CD242), Lu/B-CAM (CD239), XG1/XG2 (CD99),EMMPRIN/neurothelin (CD147), JMH, Glycosyltransferase, Cartwright,Dombrock, C4A/CAB, Scianna, MER2, stomatin, BA-1 (CD24), GPIV (CD36),CD108, CD139, and H antigen (CD173).

Additionally, new erythrocyte-specific antibodies may be generated byimmunization of mice with intact, or protein preparations of, humanerythrocytes. Following immunization with the target formulated inadjuvant, mice are sacrificed at pre-determined time points and theirantibody repertoires are sequenced and/or their B cells isolated forhybridoma-based screening. These antibodies or antibody fragments may beoptimized by several aforementioned in vitro techniques, for improvedbinding and/or stability parameters. Additional erythrocyte bindingantibodies or antibody fragments may be generated by using antibodyhybridoma clones previously discovered to bind erythrocytes. They may begenerated, for instance, by using the method used to generate the TER119scFv. As a template, or as an antibody source, the following hybridomaclones may be used, among others: BRIC 4, 5, 6, 10, 14, 18, 39, 66, 68,69, 87, 108, 110, 111, 125, 126, 128, 145, 155, 157, 163, 170, 198, 203,216, 220, 221, 222, 229, 230, 231, 235, or 256; BRAC 17, 18; BGRL 1, 2,11, 100; BRAD 3; BIRMA D6, D10, K3, 84B; 6A7; COE; or KZ1.

The term peptide is used interchangeably with the term polypeptideherein. Antibodies and antibody fragments are peptides. The termantibody fragment refers to a portion of an antibody that retains theantigen-binding function of the antibody. The fragment may literally bemade from a portion of a larger antibody or alternatively may besynthesized de novo. Antibody fragments include, for example, a singlechain variable fragment (scFv) An scFv is a fusion protein of thevariable regions of the heavy (VH) and light chains (VL) ofimmunoglobulin, connected with a linker peptide, e.g., about 10 to about50 amino acids. The linker can either connect the N-terminus of the VHwith the C-terminus of the VL, or vice versa. The term scFv includesdivalent scFvs, diabodies, triabodies, tetrabodies and othercombinations of antibody fragments. Antibodies have an antigen-bindingportion referred to as the paratope. The term peptide ligand refers to apeptide that is not part of a paratope.

The binding of erythrocytes, by antibodies and fragments thereof, bypeptidic binding ligands, and by aptamers, may be performed withoutcovalent bonding to the erythrocytes. The binding may be performed invivo and without an ex vivo erythrocyte binding event. This bindingevent, including the resultant association of an antigen with theerythrocyte, can be performed without causing the erythrocytes to beapoptotic. The process may be performed so that the surface molecules oferythrocytes are not crosslinked to each other by a crosslinking agentand/or the binding event, and are not crosslinked by covalent bonds.

Aptamers for Specific Binding of Erythrocytes

In addition to peptide ligands that bind erythrocytes, nucleotideaptamer ligands for erythrocyte surface components are taught.Accordingly, aptamers are to be made and used as described herein forother erythrocyte-binging moieties. DNA and RNA aptamers may be used toprovide non-covalent erythrocyte binding. As they are only composed ofnucleotides, aptamers are promising biomolecular targeting moieties inthat screening methodologies are well established, they are readilychemically synthesized, and pose limited side-effect toxicity and/orimmunogenicity due to their rapid clearance in vivo (Keefe, Pai, et al.,2010). Furthermore, due to the non-canonical nature of thenucleotide-target protein interaction, any productive agonist signalingupon target binding in vivo is unlikely, thus contributing lowimmunogenicity and toxicity. As such, numerous aptamer-based moleculesare currently in human clinical trials for a number of clinicalindications, including leukemia, macular degeneration, thrombosis, andtype 2 diabetes (Keefe, Pai, et al., 2010). Aptamers have also been usedas targeting agents to deliver drug payloads to specific tissues invivo, in applications such as cancer chemotherapy and fluorescence orradiological tumor detection techniques (Rockey, Huang, et al., 2011;Savla, Taratula, et al., 2011).

Aptamers are oligonucleic acids or peptides that bind to a specifictarget molecule. Aptamers are usually created to bind a target ofinterest by selecting them from a large random sequence pool. Aptamerscan be classified as DNA aptamers, RNA aptamers, or peptide aptamers.Nucleic acid aptamers are nucleic acid species that have been engineeredthrough repeated rounds of in vitro selection or Systematic Evolution ofLigands by Exponential Enrichment (SELEX) method (Archemix, Cambridge,Mass., USA) (Sampson, 2003) to specifically bind to targets such assmall molecules, proteins, nucleic acids, cells, tissues and organisms.Peptide aptamers typically have a short variable peptide domain,attached at both ends to a protein scaffold. Peptide aptamers areproteins that are designed to interfere with other protein interactionsinside cells. They consist of a variable peptide loop attached at bothends to a protein scaffold. This double structural constraint greatlyincreases the binding affinity of the peptide aptamer to be comparableto an antibody. The variable loop length is typically composed of aboutten to about twenty amino acids, and the scaffold is a protein which hasgood solubility and is compact. For example the bacterial proteinThioredoxin-A is a scaffold protein, with the variable loop beinginserted within the reducing active site, which is a -Cys-Gly-Pro-Cys-loop in the wild protein, the two Cysteines lateral chains being able toform a disulfide bridge.

Some techniques for making aptamers are detailed in Lu et al., Chem Rev2009: 109(5):1948-1998, and also in U.S. Pat. No. 7,892,734, U.S. Pat.No. 7,811,809, US 2010/0129820, US 2009/0149656, US 2006/0127929, and US2007/0111222. Example 19 further details materials and methods formaking and using aptamers for use with the embodiments disclosed herein.

Molecular Fusion

A molecular fusion may be formed between a first peptidic erythrocytebinding ligand and a second peptide. The fusion comprises the peptidesconjugated directly or indirectly to each other. The peptides may bedirectly conjugated to each other or indirectly through a linker. Thelinker may be a peptide, a polymer, an aptamer, a nucleic acid, or aparticle. The particle may be, e.g., a microparticle, a nanoparticle, apolymersome, a liposome, or a micelle. The polymer may be, e.g.,natural, synthetic, linear, or branched. A fusion protein that comprisesthe first peptide and the second peptide is an example of a molecularfusion of the peptides, with the fusion protein comprising the peptidesdirectly joined to each other or with intervening linker sequencesand/or further sequences at one or both ends. The conjugation to thelinker may be through covalent bonds. Other bonds include ionic bonds.Methods include preparing a molecular fusion or a composition comprisingthe molecular fusion, wherein the molecular fusion comprises peptidesthat specifically bind to erythrocytes and a therapeutic agent,tolerizing antigen, or other substance.

The term molecular fusion, or the term conjugated, refers to direct orindirect association by chemical bonds, including covalent,electrostatic ionic, charge-charge. The conjugation creates a unit thatis sustained by chemical bonding. Direct conjugation refers to chemicalbonding to the agent, with or without intermediate linkers or chemicalgroups. Indirect conjugation refers to chemical linkage to a carrier.The carrier may largely encapsulate the agent, e.g., a polymersome, aliposome or micelle or some types of nanoparticles, or have the agent onits surface, e.g., a metallic nanoparticle or bead, or both, e.g., aparticle that includes some of the agent in its interior as well as onits exterior. The carrier may also encapsulate an antigen forimmunotolerance. For instance a polymersome, liposome, or a particle maybe made that encapsulates the antigen. The term encapsulate means tocover entirely, effectively without any portion being exposed, forinstance, a polymersome may be made that encapsulates an antigen or anagent. Examples of therapeutic agents are single-chain variablefragments (scFv), antibody fragments, small molecule drugs, bioactivepeptides, bioactive proteins, and bioactive biomolecules.

Conjugation may be accomplished by covalent bonding of the peptide toanother molecule, with or without use of a linker. The formation of suchconjugates is within the skill of artisans and various techniques areknown for accomplishing the conjugation, with the choice of theparticular technique being guided by the materials to be conjugated. Theaddition of amino acids to the polypeptide (C- or N-terminal) whichcontain ionizable side chains, i.e. aspartic acid, glutamic acid,lysine, arginine, cysteine, histidine, or tyrosine, and are notcontained in the active portion of the polypeptide sequence, serve intheir unprotonated state as a potent nucleophile to engage in variousbioconjugation reactions with reactive groups attached to polymers, i.e.homo- or hetero-bi-functional PEG (e.g., Lutolf and Hubbell,Biomacromolecules 2003; 4:713-22, Hermanson, Bioconjugate Techniques,London. Academic Press Ltd; 1996). In some embodiments, a solublepolymer linker is used, and may be adminsited to a patient in apharmaceutically acceptable form. Or a drug may be encapsulated inpolymerosomes or vesicles or covalently attached to the peptide ligand.

An embodiment is a conjugation of a non-protein therapeutic agent and apeptide ligand, antibody, antibody fragment, or aptamer that bindsspecifically to an erythrocyte. Application of the erythrocyte bindingpeptide methodology is not restricted to polypeptide therapeutics;rather it may be translated into other drug formulations, such as smallmolecules and polymeric particles. In the long history of smallmolecules and their application in medicine, short circulationhalf-lives and poor bioavailability have consistently plagued theirefficacy in vivo. Polymeric micelles and nanoparticles represent arelatively newer generation of drug class, yet their pharmacokineticbehavior remains sub-optimal for reasons that include a high clearancerate via the action of the reticuloendothelial system (Moghimi andSzebeni, 2003). The erythrocyte-binding design can be extended to theseother drug classes to increase their circulation half-lives and clinicalefficacy.

The conjugate may comprise a particle. The erythrocyte binding peptidemay be attached to the particle. An antigen, agent, or other substancemay be in or on the particle. Examples of nanoparticles, micelles, andother particles are found at, e.g., US 2008/0031899, US 2010/0055189, US2010/0003338, which applications are hereby incorporated by referenceherein for all purposes, including combining the same with a ligand asset forth herein; in the case of conflict, however, the instantspecification controls. Examples 11 and 12 describe the creation ofcertain particles in detail.

Nanoparticles may be prepared as collections of particles having anaverage diameter of between about 10 nm and about 200 nm, including allranges and values between the explicitly articulated bounds, e.g., fromabout 20 to about 200, and from about 20 to about 40, to about 70, or toabout 100 nm, depending on the polydispersity which is yielded by thepreparative method. Various nanoparticle systems can be utilized, suchas those formed from copolymers of poly(ethylene glycol) and poly(lacticacid), those formed from copolymers of poly(ethylene oxide) andpoly(beta-amino ester), and those formed from proteins such as serumalbumin. Other nanoparticle systems are known to those skilled in thesearts. See also Devalapally et al., Cancer Chemother Pharmacol.,07-25-06; Langer et al., International Journal of Pharmaceutics,257:169-180 (2003); and Tobio et al., Pharmaceutical Research,15(2):270-275 (1998).

Larger particles of more than about 200 nm average diameterincorporating the cartilage tissue-binding ligands may also be prepared,with these particles being termed microparticles herein since they beginto approach the micron scale and fall approximately within the limit ofoptical resolution. For instance, certain techniques for makingmicroparticles are set forth in U.S. Pat. Nos. 5,227,165, 6,022,564,6,090,925, and 6,224,794.

Functionalization of nanoparticles to employ targeting capabilityrequires association of the targeting polypeptide with the particle,e.g., by covalent binding using a bioconjugation technique, with choiceof a particular technique being guided by the particle or nanoparticle,or other construct, that the polypeptide is to be joined to. In general,many bioconjugation techniques for attaching peptides to other materialsare well known and the most suitable technique may be chosen for aparticular material. For instance, additional amino acids may beattached to the polypeptide sequences, such as a cysteine in the case ofattaching the polypeptide to thiol-reactive molecules.

Example 18 details the creation of a multimeric branched polymercomprising erythrocyte specific biding moieties. To create a multimericmolecule capable of displaying multiple different bioactive molecules, acommercially available 8-arm PEG dendrimer was chemically modified toinclude reactive groups for facile conjugation reactions. The 8-armPEG-pyridyldisulfide contained the pyridyldisulfide group that reactsreadily with thiolates from small molecules and/or cysteine-containingpeptides or proteins, resulting in a disulfide-bond between the attachedbioactive moiety and the 8-arm PEG scaffold. The multimeric architectureof the 8-arm PEG allowed the conjugation of different peptides ormolecules to the scaffold, thus creating a hetero-functionalizedbiomolecule with multiple activities by virtue of its attached moieties.Heterofunctionalized fluorescent 8-arm PEG constructs, capable ofbinding erythrocytes in vitro (FIG. 16A) and in vivo (FIG. 16B) werecreated. This binding was sequence specific to the ERY1 peptide, asconjugates harboring the non-specific MIS peptide demonstrated little tono binding to erythrocytes. The binding in vivo was long-lived, asfluorescent 8-arm PEG-ERY1-ALEXAFLUOR647 was detected on circulatingerythrocytes 5 h following intravenous administration, and displayed acell-surface half-life of 2.2 h (FIG. 17). To demonstrate the inductionof tolerance in an autoimmune diabetic mouse model, an 8-arm PEGconjugated with both ERY1 and the diabetes antigen chromogranin-A (CrA)was created. The modular nature of the 8-arm PEG-pyridyldisulfidescaffold made it possible to co-conjugate different of thiol-containingmolecules by sequentially adding stoichiometrically defined quantitiesof the molecules.

The molecular fusion may comprise a polymer. The polymer may be branchedor linear. The molecular fusion may comprise a dendrimer. In general,soluble hydrophilic biocompatbile polymers may be used so that theconjugate is soluble and is bioavailable after introduction into thepatient. Examples of soluble polymers are polyvinyl alcohols,polyethylyene imines, and polyethylene glycols (a term includingpolyethylene oxides) having a molecular weight of at least 100, 400, orbetween 100 and 400,000 (with all ranges and values between theseexplicit values being contemplated). Solubility in this context refersto a solubility in water or physiological saline of at least 1 gram perliter. Domains of biodegradable polymers may also be used, e.g.,polylactic acid, polyglycolic acid, copolymers of polylactic andpolyglycolic acid, polycaprolactones, polyhydroxy butyric acid,polyorthoesters, polyacetals, polydihydropyrans, and polycyanoacylates.

In some embodiments, a polypeptide-polymer association, e.g., aconjugate, is prepared and introduced into the body as a purifiedcomposition in a pharmaceutically acceptable condition, or with apharmaceutical excipient. The site of introduction may be, e.g.,systemic, or at a tissue or a transplantation site.

Artisans may prepare fusion proteins using techniques known in thesearts. Embodiments include preparing fusion proteins, isolating them, andadministering them in a pharmaceutically acceptable form with or withoutother agents, e.g., in combination with an interleukin of TGF-beta.Embodiments include a vector for, and methods of, transfecting a cell tothereby engineer the cell to make the fusion protein in vivo, with thecell being transfected in vitro, ex vivo, or in vivo, and with the cellbeing a member of a tissue implant or distinct therefrom. The followingU.S. patent applications are hereby incorporated by reference herein forall purposes, including the purposes of making fusion proteins, with theinstant specification controlling in case of conflict: U.S. Pat. Nos.5,227,293, 5,358,857, 5,885,808, 5,948,639, 5,994,104, 6,512,103,6,562,347, 6,905,688, 7,175,988, 7,704,943, US 2002/0004037, US2005/0053579, US 2005/0203022, US 2005/0250936, US 2009/0324538.

Embodiments of a molecular fusion include, for example, a molecularfusion that comprises a tolerogenic antigen and an erythrocyte-bindingmoiety that specifically binds an erythrocyte in the patient and therebylinks the antigen to the erythrocyte, wherein the molecular fusion isadministered in an amount effective to produce immunotolerance to asubstance that comprises the tolerogenic antigen. Embodiments include,for example, a composition comprising an erythrocyte-binding moiety thatspecifically binds an erythrocyte joined to a carrier chosen from thegroup consisting of a polymer, a branched polymer, and a particle,wherein the carrier is joined to a therapeutic agent. The particle maybe, e.g., a microparticle, a nanoparticle, a polymersome, a liposome, ora micelle. The erythrocyte-binding moiety may comprises a peptidecomprising at least 5 consecutive amino acid residues of a sequencechosen from the group consisting of SEQ ID NO:11, SEQ ID NO:13, SEQ IDNO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID NO:17, SEQ ID NO:1, andconservative substitutions thereof, wherein said sequence specificallybinds an erythrocyte. The erythrocyte-binding moiety may comprise anantibody, antibody fragment, aptamer, scFv or peptide ligand.Embodiments of a molecular fusion include an erythrocyte binding moietyand a tolerogenic antigen, an antibody, an antibody fragment, an ScFv, asmall molecule drug, a particle, a protein, a peptide, or an aptamer.

In a preferred aspect of the invention there is provided a molecularfusion that comprises a tolerogenic antigen and an erythrocyte-bindingmoiety selected from Band 3 (CD233), glycophorin B (CD235b), glycophorinC (CD235c) and glycophorin D (CD235d). The molecular fusion isparticularly for use in producing immunotolerance. A preferred molecularfusion is one that comprises a tolerogenic antigen selected from: aprotein, a portion of a protein, a human protein or portion thereof, anonhuman protein or portion thereof, a glycan, a glycan of a proteinthat comprises nonhuman glycosylation, a human autoimmune antigen, aprotein therapeutic for a human or a portion thereof, and a portion of ahuman food, proteins deficient by genetic disease, proteins withnonhuman glycosylation, nonhuman proteins, synthetic proteins notnaturally found in humans, human food antigens, human transplantationantigens, and human autoimmune antigens; and an erythrocyte-bindingmoiety selected from Band 3 (CD233), glycophorin B (CD235b), glycophorinC (CD235c), glycophorin D (CD235d).

Erythrocyte Binding Ligands for Improved Pharmacokinetics

As many drugs are systemically delivered to the blood circulatorysystem, the answer to the problem of effective drug delivery oftenfocuses on maintaining the drug in the blood for extended periods oftime. Thus, the development of long-circulating (long half-life)therapeutics that remain biologically available in the blood forextended time periods will represent a new generation of drugsengineered for efficacy, safety, and economic feasibility.

Embodiments of the invention include molecular fusions of anerythrocyte-binding peptide and a therapeutic agent. Molecular fusionsbetween peptides that specifically bind to erythrocytes and atherapeutic agent or other substance provide an increased circulationtime (circulating half-life in blood in vivo) for the agent/substance.Examples 5 and 6 provide working examples of the same. The increase maybe, for instance from about 1.5-fold to 20-fold increase in serumhalf-life, artisans will immediately appreciate that all the ranges andvalues within the explicitly stated ranges are contemplated, e.g., about3-fold or about 6-fold or between about 3 fold and about 6-fold.

The molecular fusions may be accomplished by, for instance, recombinantaddition of the peptide or adding the peptide by chemical conjugation toa reactive site on the therapeutic agent or associated molecule orparticle. As solid-phase peptide synthesis can be used to synthesizehigh yields of pure peptide with varying terminal reactive groups, thereexist multiple conjugation strategies for the attachment of the peptideonto the therapeutic. Though this functionalization method differs withthe recombinant method used with proteins, the effect (erythrocytebinding leading to increased circulation half life) is postulated to bethe same.

One embodiment of the invention involves functionalization oftherapeutic agents with short peptide ligands that specifically bind toerythrocytes as tools for the improvement of pharmacokinetic parametersof the therapeutic agents. This half-life extension methodology takesinto consideration pivotal parameters in therapeutic drug design, namelysimplicity in manufacturing, modularity, and the ability to tune theextension effect. Using standard recombinant DNA techniques, proteinsare easily altered at the amino acid level to contain new or alteredfunctionalities. Generally, relying the use of shorter peptide domainsfor function is preferable to using larger polypeptide domains, forreasons that include ease in manufacturing, correct folding into afunctional therapeutic protein, and minimal biophysical alterations tothe original therapeutic itself. Polypeptides, e.g., ERY1, a humanerythrocyte binding ligand, or antibodies or antibody fragments, may beengineered to bind specifically to erythrocytes and conjugated to atherapeutic agent to extend bioavailability, e.g., as measured by thecirculating half-life of the agent.

The results reported herein provide opportunities to make molecularfusions to improve pharmacokinetic parameters of the therapeutic agentssuch as insulin, pramlintide acetate, growth hormone, insulin-likegrowth factor-1, erythropoietin, type 1 alpha interferon, interferonα2a, interferon α2b, interferon β1a, interferon β1b, interferon γ1b,β-glucocerebrosidase, adenosine deaminase, granulocyte colonystimulating factor, granulocyte macrophage colony stimulating factor,interleukin 1, interleukin 2, interleukin 11, factor VIIa, factor VIII,factor IX, exenatide, L-asparaginase, rasburicase, tumor necrosis factorreceptor, and enfuvirtide.

Attempts by others to create passive half-life improvement methods focuson increasing the apparent hydrodynamic radius of the drug. The kidney'sglomerular filtration apparatus is the primary site in the body whereblood components are filtered. The main determinant of filtration is thehydrodynamic radius of the molecule in the blood; smaller molecules (<80kDa) are filtered out of the blood to a higher extent than largermolecules. Researchers have used this generalized rule to modify drugsto exhibit a larger hydrodynamic radius and thus longer half-life,mainly via chemical conjugation to large molecular weight water-solublepolymers, such as polyethylene glycol (PEG). The success of this methodis evident in the numerous PEGylated protein and small moleculetherapeutics currently offered in the clinic (Pasut and Veronese, 2009;Fishburn, 2008). Though effective in many cases in increasingcirculation half-life, especially as the hydrodynamic radius of thegraft or fusion increases (Gao, Liu, et al., 2009), these methods offerchallenges in manufacturing and maintenance of biological effectorfunction. Heterogeneities in conjugation reactions can cause complexproduct mixtures with varying biological activities, due mostly to theutilization of site-unspecific chemistries. Extensive biochemicalcharacterization often follows precise purification methods to retain ahomogenous therapeutic product (Huang, Gough, et al., 2009; Bailon,Palleroni, et al., 2001; Dhalluin, Ross, et al., 2005). Furthermore,attachment of large moieties, such as branched PEGs, to reactive zonesof proteins can lead to decreased receptor affinity (Fishburn, 2008).

Other work by others has provided for a therapeutic protein to bind toalbumin for increased circulation of the drug (Dennis, 2002; Walker,Dunlevy, et al., 2010). Considering the same general aforementioned ruleon kidney filtration, Dennis and colleagues hypothesized that increasingthe apparent size of the therapeutic by engineering it to bind anotherprotein in the blood (such as serum albumin) would decrease the rate ofdrug clearance. In this manner, the drug attains its large molecularsize only after administration into the blood stream. The addition ofaffinity-matured serum albumin-binding peptides to antibody fragmentsincreased their circulation time 24 fold in mice (Dennis, 2002). Thougheffective, this method is complicated by the dynamics of albumin recycleby the neonatal Fc receptor (FcRn) and the use of cysteine-constrainedcyclic peptides for functionality. Walker and colleagues corroborate theresults contributed by Dennis in 2002, namely that imparting serumalbumin affinity to a protein increases its half-life. The methoddescribed by Walker and colleagues involves recombinant addition oflarge antibody fragments to the protein drug, which may cause structuralas well as manufacturing complications. Though elegant and effective,the methods of Dennis and Walker are complicated by use of complexcyclic or large domains for functionality. Though the peptidesdiscovered by Dennis and colleagues displayed high affinity for albumin,they require the physical constraint of correctly forming a cyclicstructure prior to use. A more bulky approach, Walker's method of fusinglarger antibody fragments may not be amendable to proteins with analready complex folding structure or low expression yield.

Single Chain Antibodies

An embodiment of the invention is a molecular fusion of an scFv with apeptide that specifically binds to an erythrocyte. An scFv may be used atherapeutic agent, and its combination with an erythrocyte bindingpeptide may be used to extend its circulating half-life and provideaccess to body compartments. Recombinant antibodies and recombinantantibody fragments have potential as therapeutics in the biologicsindustry (Sheridan, 2010).

Single-chain variable fragment (scFv) antibody fragments comprise of theentire antigen-binding domain of a full-length IgG, but lack the hingeand constant fragment regions (Maynard and Georgiou, 2000). Recombinantconstruction of a scFv involves fusing the variable heavy (V_(H)) domainwith the variable light (V_(L)) domain with a short polypeptide linkerconsisting of tandem repeats of glycine and serine (e.g. (GGGGS)₄) (SEQID NO:18). Though the simplicity of scFv's is attractive for therapeuticapplications, their main drawback the short circulation half lives whichthey exhibit, by virtue of their relatively small molecular weight of26-28 kDa (Weisser and Hall, 2009).

As the glycine-serine linker commonly used in scFv design isnon-functional in nature, rather it exists as a physical bridge toensure correct V_(H)-V_(L) folding, linker domains were tested hereinthat exhibit a function of binding to erythrocytes in the blood. Thus,the engineered scFv may be multifunctional and bi-specific, displayingan affinity to its native antigen through the V_(H)-V_(L) domains, andan affinity to erythrocytes in its linker domain. In binding toerythrocytes, the engineered scFv will exhibit a longer circulationhalf-life, as has been demonstrated for another model protein with thissame functionality. An scFv antibody fragment may have a linker asdescribed herein, or other linkers may be provided as is known to thoseof skill in these arts. An alternative embodiment provides for a freecysteine group engineered into the linker region of a scFv, and thiscysteine thiol used to link by chemical conjugation an erythrocytebinding ligand.

scFv antibodies were engineered as detailed in Example 7. Design of theengineered scFv antibodies focused on the importance of linker domainlength, as well as spacing of the erythrocyte binding peptide. As thewild-type variant was designed and validated for antigen binding with a(GGGGS)₄ linker (SEQ ID NO:18), subsequent mutants were designed with alinker minimum linker length of 20 amino acids (FIG. 6A). As the linkerdomain can modulate correct folding of the scFv into its correcttertiary structure (FIG. 6B), two ERY1 containing mutants were designed.The REP mutant contains the ERY1 peptide centered in the linker domain,flanked by the correct number of Gly and Ser residues to maintain theparent 20 amino acid linker length. In the possible case where thehydrophobic nature of the ERY1 peptide does not linearly align, butclusters into a shorter assembled domain, the linker length of REP wouldbe shorter and may thereby hinder correct folding. For such reasons, theINS mutant was designed to contain the ERY1 peptide added into thecenter of the parent linker domain, lengthening the linker to 32 aminoacids. As the ERY1 peptide was discovered with a free N-terminus, it wasunknown whether or not its presence in a constrained polypeptideconformation would effect erythrocyte binding. To address this potentialbehavior, a scFv variant was created by chemical conjugation withsynthetic ERY1 peptide, whereby the N-terminus of the peptide is freeand the C-terminus is conjugated to the scFv (FIG. 6C).

In this manner, the number of erythrocyte binding peptides, and thus theerythrocyte-binding capacity of an scFv, may be tuned stoichiometricallyduring the conjugation reaction. Accordingly, ScFv can be engineered tocomprise the erythrocyte-binding peptides as taught herein. Embodimentsinclude an scFv comprising a number of ligands ranging from 1 to 20;artisans will immediately appreciate that all the ranges and valueswithin the explicitly stated ranges are contemplated, e.g, between 2 and6.

Embodiments include scFv conjugated to a tolerogenic antigen to make amolecular fusion that induces tolerance, e.g., as in Example 17describing details for creating tolerance as exemplified with creationof tolerance against OVA that is attached to an scFv. Example 17 alsodetails materials and methods for making scFv protein constructsrecombinantly fused to an immune recognition epitope of an antigen. ThescFv is directed to recognition of erythrocytes. The antigen is anantigen as described herein, e.g., a tolerogenic antigen. Workingexamples reported herein describe results using murine models, with theuse of murine TER119 scFv used as the antibody domain in the constructs.TER119 is an antibody that binds to mouse erythrocytes. The TER119antibody domain may be replaced by other antibody domains, for instancedomains directed to an erythrocyte in human or other animals. Forinstance, the 10F7 antibody domain may be used to createantibody-antigen constructs capable of binding human erythrocytes.Additional fusions of scFv from Ter-119 were made with three differentantigens, as reported in Example 17, including the immunodominant MHC-Iepitope of OVA, the chromogranin-A mimotope 1040-p31, and proinsulin.

Example 24 describes other embodiments of scFvs that have been made,including embodiments for testing in animal models and embodimentsreactive for humans. These include those relating to the protein level:TER119-SIINFEKL, TER119-ChrA, and TER119-proinsulin. These also includethose relating to the genetic level: TER119-SIINFEKL, TER119-ChrA,TER119-proinsulin, TER119-uricase, TER119-InsB9-23,TER119-ISQAVHAAHAEINEAGR (SEQ ID NO:87), TER119-H-2kb, TER119-H-2kd,10F7-SIINFEKL, 10F7-ChrA, 10F7-proinsulin, and 10F7-uricase.

Embodiments include scFvs that bind a tumor marker and block blood flowto a tumor, as in Examples 10 and 13. For instance, the scFv may bindthe tumor marker and further be part of a molecular fusion with anerythrocyte-binding peptide. These conjugates may also be used to treatcancer by blocking blood flow to a tumor.

Binding of Erythrocytes to Particular Sites, Such as Tumor Vasculature

In addition to increasing the half-life of a drug, the capacity of anengineered therapeutic to bind erythrocytes is useful in order toselectively bind and localize erythrocytes to a particular site in thebody. In treatment of solid tumors, transarterial chemoembolization(TACE) may be used to limit blood supply to the tumor, thereby hinderingits access to nutrients required for growth. TACE treatment involves thesurgical insertion of polymeric solid microparticles upstream of thetumor blood supply. As the microparticles reach the tumor vascular bed,they become physically trapped in the blood vessel network therebycreating a blockage for blood supply to the tumor (Vogl, Naguib, et al.,2009).

Pursuant to the TACE theme, an embodiment herein is to use autologouserythrocytes circulating in the blood as natural microparticles fortumor embolization by engineering a tumor-homing therapeutic to containan erythrocyte-binding peptide. In this manner, the therapeuticlocalizes to the tumor vascular bed and recruits passing erythrocytes tobind to the vessel, thereby limiting and blocking blood flow to thetumor mass. Such a treatment is less invasive than classical TACE: thedrug would be simply injected intravenously and use natural erythrocytesalready present in the blood as the embolization particle. The termtumor-binding or tumor-homing refers to a peptide that binds to acomponent accessible from the blood compartment in tumor vasculature oron tumor cells.

Discovery of specific tumor-homing therapeutics is known in the cancerresearch field. The paradigm of bioactive targeting of tumors relies onbinding to protein markers specifically expressed in the tumorenvironment. These include, but are not limited to: RGD-directedintegrins, aminopeptidase-A and -N, endosialin, cell surface nucleolin,cell surface annexin-1, cell surface p32/ gClq receptor, cell surfaceplectin-1, fibronectin EDA and EDB, interleukin 11 receptor α,tenascin-C, endoglin/CD105, BST-2, galectin-1, VCAM-1, fibrin, andtissue factor receptor. (Fonsatti, Nicolay, et al., 2010; Dienst,Grunow, et al., 2005; Ruoslahti, Bhatia, et al., 2010; Thijssen, Postel,et al., 2006; Schliemann, Roesli, et al., 2010; Brack, Silacci, et al.,2006; Rybak, Roesli, et al., 2007). A therapeutic targeted towards anyof these molecules may be a vector to carry an erythrocyte-bindingpeptide to the tumor vasculature to cause specific occlusion.

An embodiment is a first ligand that specifically binds erythrocytesconjugated with a second ligand that specifically binds to a cancerouscell or the tumor vasculature or a component of the tumor vasculature,such as a protein in the subendothelium (which is partially exposed tothe blood in a tumor) or a protein on the surface of a tumor endothelialcell. The ligand may be part of a pharmaceutically acceptablecomposition that is introduced into a patient, e.g., into thebloodstream. The ligands bind to erythrocytes and the tumor-homingligand binds to a site at or near the tumor or tumor vasculature, or toa cancerous cell. The erythrocytes collect at the targeted site andblock access of the target site to nutrients, e.g., by embolizing ablood vessel. Given that the embolization is mechanical, beingdetermined by the physical size of the erythrocyte, embolization will besudden.

Solid tumors depend heavily on their vascular supply, and biomoleculartherapeutics as well as material therapeutics have been developed toeither block growth of their vascular supply or to block flow to theirvascular supply. An embodiment is a biomolecular formulation or abiomolecular-nanoparticulate formulation that is to be systemicallyinjected to rapidly occlude the vasculature of solid tumors, in theprimary tumor or in the metastases at known or unknown locations.

Tumor embolization has been approached in a number of ways, includingthe use of particle and biomolecular based methods. Biomaterialparticles, including those made of polyvinyl alcohol, are of a diametergreater than the tumor microvasculature, e.g. 50-500 micrometers indiameter, and have been developed for use clinically in transcatheterarterial embolization, or TACE (Maluccio, Covey, et al., 2008). Aparallel approach includes chemotherapeutics loaded inside the particlesfor slow release in transarterial chemoembolization (TACE) used mainlyfor the treatment for hepatocellular carcinoma (Gadaleta and Ranieri,2010). In both cases, when particles are injected into the arterialcirculation, usually by an interventional radiologist under radiographicguidance, these particles can flow into the tumor vasculature andocclude them, blocking flow (Maluccio, Covey, et al., 2008). With theselocal approaches, only the tumor that is directly targeted by theplacement of the catheter is treated, and other tumors, such asmetastases at known or unknown locations, go untreated since theparticles are not easily targeted in the vessels. More recently,biomolecular approaches have been explored, for example using bispecificantibodies that recognize both a thrombosis factor and a tumor vascularendothelial marker not present in normal vasculature. After bindingspecifically to the tumor vasculature, the antibody accumulates andinitiates the formation of blood clots within the tumor vessels to blockthem; this effect was only induced when the antibody was targeted to thetumor (Huang, Molema, et al., 1997). These biomolecular approaches havea benefit of targeting both primary and secondary tumors fromintravenous infusions if specific tumor vascular signatures can beidentified; yet they have a disadvantage of not providing suddenmechanical occlusion to the tumor.

Embodiments of the invention include a method of embolizing a tumor in apatient comprising administering a composition to a patient thatcomprises an erythrocyte-binding moiety coupled to a targeting moiety,wherein the targeting moiety is an antibody, antibody fragment, orpeptide that is directed to a target chosen from the group consisting ofa tumor and tumor microvasculature, and wherein the erythrocyte-bindingmoiety comprises a peptide, an antibody, an antibody fragment, or anaptamer that specifically binds erythrocytes. The peptide may be, e.g.,a sequence as set forth herein.

Antigen-Specific Immunological Tolerance

In addition to improving the pharmacokinetic behavior of a therapeuticagent, it has been discovered that erythrocyte affinity may be used inmethods of creating antigen-specific tolerance. Certain working andprophetic embodiments are set forth in the Examples. Tolerogenesis, asdemonstrated herein, can result in elimination of circulating antibodiesagainst an antigen, or reduction of circulating antibodies against anantigen by a factor of at least 10, i.e., at least 100, at least 1000,or more than 10,000. Tolerogenesis can prevent, cure, or slow diseaseprogression, reduce or eliminate rejection of a transplanted tissue, andreduce or eliminate an allergic reaction to a substance.

Examples 14 and 21-23 detail how tolerance was created in mouse animalmodels predictive of human behavior. Example 14 showed the creation oftolerance using a test antigen (ovalbumin) connected to a peptide ligandthat binds an erythrocyte surface. Examples 21-23 corroborate theresults of Example 14 and provide further working examples showingcreation of tolerance using ovalbumin attached to an scFv andasparaginase attached to a peptidic ligand. A working example showingcreation of tolerance that reverses pre-existing immunorejection isprovided in Example 23. Accordingly, embodiments include a fusionmolecule for tolerogenesis comprising asparaginase, an antigenicasparaginase fragment, of an antigenic mimotope of asparaginase and anerythrocyte-binding moiety, with the erythrocyte-binding moietyspecifically binding, for instance, glycophorin A or a target chosenfrom the group consisting of Band 3, glycophorin B, glycophorin C orother members of the Erythrocyte Target Group. The erythrocyte-bindingmoiety may be, for instance, chosen from the group consisting ofantibodies, antibody fragments, scFvs, peptide ligands and aptamersand/or from the group consisting of ERY19, ERY59, ERY64, ERY123, ERY141,ERY162, ERY19′, ERY59′, ERY64′, ERY123′, ERY141′, and ERY162′ andconservative substitutions thereof. These fusion molecules may beapplied prophylacticly before a first administration of asparaginase,during a course of treatment with asparaginase, and/or after a course oftreatment with asparaginase. These fusion molecules may be appliedbefore an immune response to asparaginase drug is observed, or aftersuch a response is observed.

In Example 14, a peptide the binds mouse erythrocytes, ERY1, had beendiscovered. A molecular fusion of ERY1 was made with a test antigen,ovalbumin (OVA). The fusion bound specifically bound to erythrocytes invivo and did not bind other molecules, including those in blood or thevasculature. A lengthy circulating half-life was observed. Erythrocytebinding of ERY1-OVA was observed to lead to efficient cross-presentationof the OVA immunodominant MEW I epitope (SIINFEKL) by antigen-presentingcells (APCs) and corresponding cross-priming of reactive T cells.ERY1-OVA induced much higher numbers of annexin-V⁺ proliferating OT-ICD8⁺ T cells than OVA (FIG. 12d ), suggesting an apoptotic fate thatwould eventually lead to clonal deletion. Using an established OT-Ichallenge-to-tolerance model (Liu, Iyoda, et al., 2002) (FIG. 14a ),ERY1-OVA was demonstrated to prevent subsequent immune responses tovaccine-mediated antigen challenge, even with a very strongbacterially-derived adjuvant. Intravenous administration of ERY1-OVAresulted in profound reductions in OT-I CD8⁺ T cell populations in thedraining lymph nodes (FIG. 14; gating in FIG. 14b ) and spleens comparedwith mice administered unmodified OVA prior to antigen challenge withLPS (FIG. 14c ), demonstrating deletional tolerance. This effectiveclonal deletion exhibited in mice administered ERY1-OVA supportedearlier observations of enhanced OT-I CD8⁺ T cell cross-priming (FIG.12) and furthermore shows that cross-priming occurred in the absence ofAPC presentation of co-stimulatory molecules to lead to deletionaltolerance. Intravenous administrations of ERY1-OVA caused a 39.8-foldlower OVA-specific serum IgG levels 19 d after the first antigenadministration (FIG. 15) as compared to OVA-treated mice. To furthervalidate the induction of antigen-specific immune tolerance, the OT-Ichallenge-to-tolerance model was combined with an OVA-expressing tumorgraft model (FIG. 14), with favorable results. The results detailed inthis Example demonstrate that erythrocyte binding by ERY1-OVA inducesantigen-specific immune tolerance. This was shown in response to astrongly adjuvanted challenge as well as implanted cellular graftsexpressing a xeno-antigen. Moreover, tolerance was acheived byfunctional inactivation and deletion of reactive CD8⁺ T cells throughinteraction with antigen present on circulating erythrocytes,independent of direct CD4⁺ T cell regulation. These detailed experimentswith ERY1, a mouse erythrocyte binding peptide, are predictive ofsimilar results in humans using human erythrocyte binding peptides,several of which are taught herein. Moreover, having shown that peptideligands are effective, similar results may be made using conjugates withother erythrocyte binding ligands, e.g., antibodies, antibody fragments,or aptamers, with these moieties binding a surface molecule of anerythrocyte, for example, one of the surface proteins or antigens setforth herein.

Example 21 further demonstrated the creation of tolerance to atolerogenic antigen by fusing the tolerogenic antigen to an scFv thatbinds an erythrocyte, and preparing the fusion molecule as a medicamentfor administration to a patient. Example 21 demonstrates induction oftolerance to the MHC-I immunodominant domain of OVA, which is thepeptide SIINFEKL (SEQ ID NO:3). This antigen was fused to the scFvTER-119, which is known to bind to mouse erythrocytes. OT-I CD8⁺ T cellproliferation, determined by dilution of the fluor CFSE as measured byflow cytometry, was markedly enhanced in mice administeredTER119-SIINFEKL compared to ERY1-OVA or OVA (FIG. 20), demonstratingthat erythrocyte-binding increased antigen-specific CD8⁺ T cellcross-priming compared to the soluble antigen SIINFEKL. Furthermore,these data demonstrate that antibody fragments designed to binderythrocytes and display immune epitopes are efficiently processed byimmune cells to cross-prime antigen specific T cells. These results oncross-presentation and cross-priming are consistent with other studiesconcerning tolerogenic antigen presentation on MHC I by APCs engulfingantigen from apoptotic cells (Albert 1998, Green 2009). TER119-SIINFEKLand ERY1-OVA induced much higher numbers of annexin-V⁺ and PD-1⁺proliferating OT-I CD8⁺ T cells than OVA (FIG. 21), indicating anexhausted and apoptotic fate that leads to clonal deletion. Thisphenotype of proliferating CD8⁺ T cells is consistent with otherreported OT-I adoptive transfer models in which regulatedantigen-specific T cell receptor engagement by APCs fails to induceinflammatory responses (Bursch, Rich, et al., 2009).

Referring to Example 21, the ability of TER119-SIINFEKL and ERY1-OVA toprevent subsequent immune responses to a vaccine-mediated antigenchallenge were demonstrated—even when challenged with a very strongbacterially-derived adjuvant. Fusion molecules with either an scFv or apeptide ligand for binding an erythrocyte were thus effective to producetolerance.

Example 22 shows that it is possible to induce antigen-specific immunetolerance towards therapeutic proteins and proteins with therapeuticpotential. Many therapeutic proteins induce immune reactions, renderingtheir clinical use dangerous or ineffective. Asparaginase is amicrobially-derived therapeutic enzyme used to treat acute lymphoblasticleukemia, yet also induces dangerous immune responses that obviate itsrepeated use. A mouse model was used. A fusion molecule of asparaginaseand an erythrocyte-binding moiety (the peptide ERY1) was administered tomice and compared to mice treated with the clinical drug asparaginase.The drug asparaginase produced antibodies but the fusion molecule didnot; this test established that antibody levels could be used as ameasure of tolerance. Tolerance was then proven by administering thefusion molecule to mice followed by repeated administration of theclinical drug asparaginase, and observing that there was no potentantibody response, even after a very aggressive challenge by repeateddosing with the drug. In contrast, mice that received the drug but notthe fusion molecule became immunoreactive and dangerouslyhypersensitive.

Example 23 shows that immunoreversal is possible. Mice that wereimmunoreactive to a protein were treated to become tolerant of theprotein. The asparaginase mouse model of Example 22 was used. Mice thatwere immunoreactive to the drug asparaginase were treated with thefusion molecule (asparaginase-and-erythrocyte binder) and becametolerant of the drug asparaginase.

In contrast, prior reports teach that immunorejection is created byattaching an antigen to a surface of an erythrocyte to thereby make avaccine, and other reports have used antigens encapsulated withinerythrocytes to create vaccines. For instance when antigen isencapsulated within an erythrocyte, a vaccine is thereby made (Murray etal., Vaccine 24: 6129-6139 (2006)). Or antigens conjugated to anerythrocyte surface were immunogenic and proposed as vaccines(Chiarantini et al., Vaccine 15(3): 276-280 (1997)). These referencesshow that the erythrocyte delivery approach an immune response as goodas those obtained with normal vaccines with adjuvants. Others havereported that placement within an erythrocyte is needed for inducingtolerance, as in patent application WO 2011/051346, which also teachesseveral means by which to alter the erythrocyte surface to enhanceclearance by Kupffer cells in the liver. This same application alsoteaches binding antibodies to erythrocyte surface proteins such asglycophorin A, but for the purpose of making immune complexes on theerythrocyte to enhance its clearance by Kupffer cells.

Embodiments set forth herein provide for a method of producingimmunotolerance, the method comprising administering a compositioncomprising a molecular fusion that comprises a tolerogenic antigen andan erythrocyte-binding moiety that specifically binds an erythrocyte inthe patient and thereby links the antigen to the erythrocyte, whereinthe molecular fusion is administered in an amount effective to produceimmunotolerance to a substance that comprises the tolerogenic antigen.The erythrocyte, and patient, may be free of treatments that cause otheralterations to erythrocytes, and free of erythrocyte crosslinking,chemical covalent conjugations, coatings, and other alterations otherthan the specific binding of the peptide. The molecular fusion maycomprise, or consist of, the erythrocyte-binding moiety directlycovalently bonded to the antigen. The molecular fusion may comprise theerythrocyte-binding moiety attached to a particle that is attached tothe antigen. The particle may comprise a microparticle, a nanoparticle,a liposome, a polymersome, or a micelle. The tolerogenic antigen maycomprise a portion of a therapeutic protein, e.g., a blood factoradministered to a patient suffering from a lack of production of thefactor. Embodiments include the instances wherein: the patient is ahuman and the tolerogenic antigen is a human protein of which thepatient is genetically deficient; wherein the patient is a human and thetolerogenic antigen comprises a portion of a nonhuman protein; whereinthe patient is a human and the tolerogenic antigen comprises a portionof an engineered therapeutic protein not naturally found in a human;wherein the patient is a human and the tolerogenic antigen comprises aportion of a protein that comprises nonhuman glycosylation; wherein thetolerogenic antigen comprises a portion of a human autoimmune diseaseprotein; wherein the tolerogenic antigen is an antigen in allografttransplantation; wherein the tolerogenic antigen comprises a portion ofa substance chosen from the group consisting of human food; and/orwherein the erythrocyte-binding moiety is chosen from the groupconsisting of a peptide, an antibody, and an antibody fragment.Embodiments include tolerization materials and methods wherein theerythrocyte-binding moiety comprises a peptide comprising at least 5consecutive amino acid residues of a sequence chosen from the groupconsisting of SEQ ID NO:11, SEQ ID NO:13, SEQ ID NO:14, SEQ ID NO:15,SEQ ID NO:16, SEQ ID NO:17, SEQ ID NO:1, and conservative substitutionsthereof, wherein said sequence specifically binds an erythrocyte.

The molecular fusion may be chosen to place the antigen on the inside orthe outside of the erythrocyte. Without being bound to a particularmechanism of action, the following theory is presented. In man,approximately 1% of erythrocytes become apoptotic (eryptotic) and arecleared each day, a large number of cells, and their proteins areprocessed in a manner so as to maintain tolerance to the erythrocyteself-antigens. An antigen engineered to bind to erythrocytes through theuse of the ERY1 peptide or a human erythrocyte binding peptide, anerythrocyte-binding single chain antibody or antibody, anerythrocyte-binding aptamer, or another erythrocyte-binding agent mayalso elicit the same tolerogenic response. Given that the currentstate-of-the-art method developed by Miller and colleagues (see above)is cumbersome, in that it requires harvesting and reacting donorsplenocytes for re-administration, our non-covalent erythrocyte-bindingmethod provides a simpler alternative. As the ERY1-erythrocyte or humanerythrocyte binding peptide-erythrocyte or other affinity biomolecule(single chain antibody, antibody, or aptamer, for example) interactionoccurs spontaneously after introduction of the antigen conjugate orfusion in vivo, the engineered antigen is simply administered byinjection, and binding occurs in situ.

In some cases, the tolerogenic antigen is derived from a therapeuticagent protein to which tolerance is desired. Examples are protein drugsin their wild type, e.g., human factor VIII or factor IX, to whichpatients did not establish central tolerance because they were deficientin those proteins; or nonhuman protein drugs, used in a human. Otherexamples are protein drugs that are glycosylated in nonhuman forms dueto production, or engineered protein drugs, e.g., having non-nativesequences that can provoke an unwanted immune response. Examples oftolerogenic antigens that are engineered therapeutic proteins notnaturally found in humans include human proteins with engineeredmutations, e.g., mutatuions to improve pharmacological characteristics.Examples of tolerogenic antigens that comprise nonhuman glycosylationinclude proteins produced in yeast or insect cells.

Embodiments include administering a protein at some frequency X or doseY and also administering an antigen from that protein at a lesserfrequency and/or dose, e.g., a frequency that is not more than 0.2X or adose that is not more than 0.2Y; artisans will immediately appreciatethat all the ranges and values within the explicitly stated ranges arecontemplated, e.g., 0.01 or 005 X or some range therebetween.

Embodiments include choosing the tolerogenic antigen from proteins thatare administered to humans that are deficient in the protein. Deficientmeans that the patient receiving the protein does not naturally produceenough of the protein. Moreover, the proteins may be proteins for whicha patient is genetically deficient. Such proteins include, for example,antithrombin-III, protein C, factor VIII, factor IX, growth hormone,somatotropin, insulin, pramlintide acetate, mecasermin (IGF-1), β-glucocerebrosidase, alglucosidase-α, laronidase (α-L-iduronidase),idursuphase (iduronate-2-sulphatase), galsulphase, agalsidase-β(α-galactosidase), α-1 proteinase inhibitor, and albumin. Accordingly,embodiments include a fusion molecule for tolerogenesis comprising anerythrocyte-binding moiety and at least one antigen, antigenic fragment,or antigenic mimotope of one or more of these proteins, with theerythrocyte-binding moiety specifically binding, for instance,glycophorin A or a target chosen from the group consisting of Band 3,glycophorin B, glycophorin C or other members of the Erythrocyte TargetGroup. The erythrocyte-binding moiety may be, for instance, chosen fromthe group consisting of antibodies, antibody fragments, scFvs, peptideligands and aptamers.

Embodiments include choosing the tolerogenic antigen from therapeuticantibodies and antibody-like molecules, including antibody fragments andfusion proteins with antibodies and antibody fragments. These includenonhuman (such as mouse) antibodies, chimeric antibodies, and humanizedantibodies. Immune responses to even humanized antibodies have beenobserved in humans (Getts, 2010). Accordingly, embodiments include afusion molecule for tolerogenesis comprising an erythrocyte-bindingmoiety and at least one antigen, antigenic fragment, or antigenicmimotope of one or more of these proteins, with the erythrocyte-bindingmoiety specifically binding, for instance, glycophorin A or a targetchosen from the group consisting of Band 3, glycophorin B, glycophorin Cor other members of the Erythrocyte Target Group. Theerythrocyte-binding moiety may be, for instance, chosen from the groupconsisting of antibodies, antibody fragments, scFvs, peptide ligands andaptamers.

Embodiments include choosing the tolerogenic antigen from proteins thatare nonhuman. Examples of such proteins include adenosine deaminase,pancreatic lipase, pancreatic amylase, lactase, botulinum toxin type A,botulinum toxin type B, collagenase, hyaluronidase, papain,L-Asparaginase, rasburicase, lepirudin, streptokinase, anistreplase(anisoylated plasminogen streptokinase activator complex), antithymocyteglobulin, crotalidae polyvalent immune Fab, digoxin immune serum Fab,L-arginase, and L-methionase.

Embodiments include choosing the tolerogenic antigen from humanallograft transplantation antigens. Examples of these antigens are thesubunits of the various MHC class I and MHC class II haplotype proteins,and single-amino-acid polymorphisms on minor blood group antigensincluding RhCE, Kell, Kidd, Duffy and Ss. A

In some cases, the tolerogenic antigen is a self antigen against which apatient has developed an autoimmune response or may develop anautoimmune response. Examples are proinsulin (diabetes), collagens(rheumatoid arthritis), myelin basic protein (multiple sclerosis).

For instance, Type 1 diabetes mellitus (T1D) is an autoimmune diseasewhereby T cells that recognize islet proteins have broken free of immuneregulation and signal the immune system to destroy pancreatic tissue.Numerous protein antigens that are targets of such diabetogenic T cellshave been discovered, including insulin, GAD65, chromogranin-A, amongothers. In the treatment or prevention of T1D, it would be useful toinduce antigen-specific immune tolerance towards defined diabetogenicantigens to functionally inactivate or delete the diabetogenic T cellclones. Example 25 details how a fusion molecule presenting thechromogranin-A (ChrA) mimotope as a tolerogenic antigen successfullycreated tolerogenesis to ChrA, based on T-cell data that was establishedas predictive in the other Examples. Accordingly, embodiments include afusion molecule for tolerogenesis comprising chromogranin-A, an antigenor antigenic portion thereof, or a mimotope of the same with anerythrocyte-binding moiety, with the erythrocyte-binding moietyspecifically binding, for instance, glycophorin A or a target chosenfrom the group consisting of Band 3, glycophorin B, glycophorin C orother members of the Erythrocyte Target Group. The erythrocyte-bindingmoiety may be, for instance, chosen from the group consisting ofantibodies, antibody fragments, scFvs, peptide ligands and aptamersand/or from the group consisting of ERY19, ERY59, ERY64, ERY123, ERY141,ERY162, ERY19′, ERY59′, ERY64′, ERY123′, ERY141′, ERY162′ andconservative substitutions thereof.

Accordingly, tolerance and/or delay of onset or progression ofautoimmune diseases may be achieved for various of the many proteinsthat are human autoimmune proteins, a term referring to variousautoimmune diseases wherein the protein or proteins causing the diseaseare known or can be established by routine testing.

Embodiments include testing a patient to identify an autoimmune proteinand creating an antigen for use in a molecular fusion and creatingimmunotolerance to the protein. Embodiments include an antigen, orchoosing an antigen from, one or more of the following proteins. In type1 diabetes mellitus, several main antigens have been identified:insulin, proinsulin, preproinsulin, glutamic acid decarboxylase-65(GAD-65), GAD-67, insulinoma-associated protein 2 (IA-2), andinsulinoma-associated protein 2β (IA-2β); other antigens include ICA69,ICA12 (SOX-13), carboxypeptidase H, Imogen 38, GLIMA 38, chromogranin-A,HSP-60, caboxypeptidase E, peripherin, glucose transporter 2,hepatocarcinoma-intestine-pancreas/pancreatic associated protein,S1001β, glial fibrillary acidic protein, regenerating gene II,pancreatic duodenal homeobox 1, dystrophia myotonica kinase,islet-specific glucose-6-phosphatase catalytic subunit-related protein,and SST G-protein coupled receptors 1-5. In autoimmune diseases of thethyroid, including Hashimoto's thyroiditis and Graves' disease, mainantigens include thyroglobulin (TG), thyroid peroxidase (TPO) andthyrotropin receptor (TSHR); other antigens include sodium iodinesymporter (NIS) and megalin. In thyroid-associated ophthalmopathy anddermopathy, in addition to thyroid autoantigens including TSHR, anantigen is insulin-like growth factor 1 receptor. In hypoparathyroidism,a main antigen is calcium sensitive receptor. In Addison's disease, mainantigens include 21-hydroxylase, 17α-hydroxylase, and P450 side chaincleavage enzyme (P450scc); other antigens include ACTH receptor, P450c21and P450c17. In premature ovarian failure, main antigens include FSHreceptor and α-enolase. In autoimmune hypophysitis, or pituitaryautoimmune disease, main antigens include pituitary gland-specificprotein factor (PGSF) 1a and 2; another antigen is type 2 iodothyroninedeiodinase. In multiple sclerosis, main antigens include myelin basicprotein, myelin oligodendrocyte glycoprotein and proteolipid protein. Inrheumatoid arthritis, a main antigen is collagen II. In immunogastritis,a main antigen is H⁺,K⁺-ATPase. In pernicious angemis, a main antigen isintrinsic factor. In celiac disease, main antigens are tissuetransglutaminase and gliadin. In vitiligo, a main antigen is tyrosinase,and tyrosinase related protein 1 and 2. In myasthenia gravis, a mainantigen is acetylcholine receptor. In pemphigus vulgaris and variants,main antigens are desmoglein 3, 1 and 4; other antigens includepemphaxin, desmocollins, plakoglobin, perplakin, desmoplakins, andacetylcholine receptor. In bullous pemphigoid, main antigens includeBP180 and BP230; other antigens include plectin and laminin 5. Indermatitis herpetiformis Duhring, main antigens include endomysium andtissue transglutaminase. In epidermolysis bullosa acquisita, a mainantigen is collagen VII. In systemic sclerosis, main antigens includematrix metalloproteinase 1 and 3, the collagen-specific molecularchaperone heat-shock protein 47, fibrillin-1, and PDGF receptor; otherantigens include Scl -70, U1 RNP, Th/To, Ku, Jol , NAG-2, centromereproteins, topoisomerase I, nucleolar proteins, RNA polymerase I, II andIII, PM-Slc, fibrillarin, and B23. In mixed connective tissue disease, amain antigen is U1snRNP. In Sjogren's syndrome, the main antigens arenuclear antigens SS-A and SS-B; other antigens include fodrin,poly(ADP-ribose) polymerase and topoisomerase. In systemic lupuserythematosus, main antigens include nuclear proteins including SS-A,high mobility group box 1 (HMGB1), nucleosomes, histone proteins anddouble-stranded DNA. In Goodpasture's syndrome, main antigens includeglomerular basement membrane proteins including collagen IV. Inrheumatic heart disease, a main antigen is cardiac myosin. Otherautoantigens revealed in autoimmune polyglandular syndrome type 1include aromatic L-amino acid decarboxylase, histidine decarboxylase,cysteine sulfinic acid decarboxylase, tryptophan hydroxylase, tyrosinehydroxylase, phenylalanine hydroxylase, hepatic P450 cytochromes P4501A2and 2A6, SOX-9, SOX-10, calcium-sensing receptor protein, and the type 1interferons interferon alpha, beta and omega. Example 26 providesdetailed guidance for tolerogenesis to such proteins, and specificallydescribes a process with insulin as an example.

In some cases, the tolerogenic antigen is a foreign antigen againstwhich a patient has developed an unwanted immune response. Examples arefood antigens. Embodiments include testing a patient to identify foreignantigen and creating a molecular fusion that comprises the antigen andtreating the patient to develop immunotolerance to the antigen or food.Examples of such foods and/or antigens are provided. Examples are frompeanut: conarachin (Ara h 1), allergen II (Ara h 2), arachis agglutinin,conglutin (Ara h 6); from apple: 31 kda major allergen/diseaseresistance protein homolog (Mal d 2), lipid transfer protein precursor(Mal d 3), major allergen Mal d 1.03 D (Mal d 1); from milk:α-lactalbumin (ALA), lactotransferrin; from kiwi: actinidin (Act c 1,Act d 1), phytocystatin, thaumatin-like protein (Act d 2), kiwellin (Actd 5); from mustard: 2S albumin (Sin a 1), 11S globulin (Sin a 2), lipidtransfer protein (Sin a 3), profilin (Sin a 4); from celery: profilin(Api g 4), high molecular weight glycoprotein (Api g 5); from shrimp:Pen a 1 allergen (Pen a 1), allergen Pen m 2 (Pen m 2), tropomyosin fastisoform; from wheat and/or other cerials: high molecular weightglutenin, low molecular weight glutenin, alpha- and gamma-gliadin,hordein, secalin, avenin; from strawberry: major strawberry allergy Fraa 1-E (Fra a 1), from banana: profilin (Mus xp 1).

Many protein drugs that are used in human and veterinary medicine induceimmune responses, which creates risks for the patient and limits theefficacy of the drug. This can occur with human proteins that have beenengineered, with human proteins used in patients with congenitaldeficiencies in production of that protein, and with nonhuman proteins.It would be advantageous to tolerize a recipient to these protein drugsprior to initial administration, and it would be advantageous totolerize a recipient to these protein drugs after initial administrationand development of immune response. In patients with autoimmunity, theself-antigen(s) to which autoimmunity is developed are known. In thesecases, it would be advantageous to tolerize subjects at risk prior todevelopment of autoimmunity, and it would be advantageous to tolerizesubjects at the time of or after development of biomolecular indicatorsof incipient autoimmunity. For example, in Type 1 diabetes mellitus,immunological indicators of autoimmunity are present before broaddestruction of beta cells in the pancreas and onset of clinical diseaseinvolved in glucose homeostasis. It would be advantageous to tolerize asubject after detection of these immunological indicators prior to onsetof clinical disease.

Recent work by headed by Miller and colleagues has shown that covalentlyconjugating an antigen to allogenic splenocytes ex vivo createsantigen-specific immune tolerance when administered intravenously inmice (Godsel, Wang, et al., 2001; Luo, Pothoven, et al., 2008). Theprocess involves harvesting donor splenic antigen-presenting cells andchemically reacting them in an amine-carboxylic acid crosslinkingreaction scheme. The technique has proven effective in inducingantigen-specific tolerance for mouse models of multiple sclerosis(Godsel, Wang, et al., 2001), new onset diabetes type 1 (Fife, Guleria,et al., 2006), and allogenic islet transplants (Luo, Pothoven, et al.,2008). Though the exact mechanism responsible for the tolerogenicresponse is not known, it is proposed that a major requirement involvesantigen presentation without the expression of co-stimulatory moleculeson apoptotic antigen-coupled cells (Miller, Turley, et al., 2007). Ithas also been contemplated to encapsulate antigens within erythrocyteghosts, processing the erythrocytes ex vivo and re-injecting them, as inWO2011/051346.

Administration

Many embodiments of the invention set forth herein describe compositionsthat may be administered to a human or other animal patient. Embodimentsof the invention include, for example, molecular fusions, fusionproteins, peptide ligands, antibodies, scFv, that recognize antigens onerythrocytes or tumors or tumor vasculature, as well as combinationsthereof. These compositions may be prepared as pharmaceuticallyacceptable compositions and with suitable pharmaceutically acceptablecarriers or excipients.

The compositions that bind erythrocytes may do so with specificity. Thisspecificity provides for in vivo binding of the compositions with theerythrocytes, as well as alternative ex vivo processes. Accordingly, thecompositions may be directly injected into a vasculature of the patient.An alternative is injection into a tissue, e.g., muscle, dermal, orsubcutaneous, for subsequent erythrocyte contact and uptake. Anembodiment of the invention is a method of inducing tolerogenesis in apatient comprising administering a tolerizing antigen to the patient inassociation with an erythrocyte-binding moiety to thereby attach theantigen to an erythrocyte in vivo; the in vivo attachment can thus beperformed without ex vivo processing of erythrocytes. This process maybe performed wherein the erythrocyte is not made to be apoptotic as aresult of the process. This process may be performed so that it is freeof (does not involve) exposing the erythrocytes to one or more of: acrosslinking agent; a crosslinking agent that crosslinks surfacemolecules of an erythrocyte; a crosslinking agent comprising at leasttwo functional groups; a crosslinking agent that forms a covalent bindwith an erythrocyte; functional groups that form a covalent bond with anerythrocyte; and an antigen and/or antigenic substance that covalentlybonds to the erythrocyte. The process may be performed so that theerythrocytes and/or the antigens are free of1-ethyl-3-(3-dimethylaminopropyl) carbodiimide) (EDC; also EDAC or EDCI)and may also be free of any reactions with a carbodiimide. This processmay be performed with autologous erythrocytes and may be free ofallogeneic erythrocytes.

Pharmaceutically acceptable carriers or excipients may be used todeliver embodiments as described herein. Excipient refers to an inertsubstance used as a diluent or vehicle for a therapeutic agent.Pharmaceutically acceptable carriers are used, in general, with acompound so as to make the compound useful for a therapy or as aproduct. In general, for any substance, a pharmaceutically acceptablecarrier is a material that is combined with the substance for deliveryto an animal. Conventional pharmaceutical carriers, aqueous, powder oroily bases, thickeners and the like may be necessary or desirable. Insome cases the carrier is essential for delivery, e.g., to solubilize aninsoluble compound for liquid delivery; a buffer for control of the pHof the substance to preserve its activity; or a diluent to prevent lossof the substance in the storage vessel. In other cases, however, thecarrier is for convenience, e.g., a liquid for more convenientadministration. Pharmaceutically acceptable salts of the compoundsdescribed herein may be synthesized according to methods known to thoseskilled in the arts. Thus pharmaceutically acceptable compositions arehighly purified to be free of contaminants, are biocompatible and nottoxic, are suited to administration to a patient. In the case of wateras the carrier, the water is highly purified and processed to be free ofcontaminants, e.g., endotoxins.

The compounds described herein are typically to be administered inadmixture with suitable pharmaceutical diluents, excipients, extenders,or carriers (termed herein as a pharmaceutically acceptable carrier, ora carrier) suitably selected with respect to the intended form ofadministration and as consistent with conventional pharmaceuticalpractices. Thus the deliverable compound may be made in a form suitablefor oral, rectal, topical, intravenous injection, intra-articularinjection, or parenteral administration. Carriers include solids orliquids, and the type of carrier is chosen based on the type ofadministration being used. Suitable binders, lubricants, disintegratingagents, coloring agents, flavoring agents, flow-inducing agents, andmelting agents may be included as carriers, e.g., for pills. Forinstance, an active component can be combined with an oral, non-toxic,pharmaceutically acceptable, inert carrier such as lactose, gelatin,agar, starch, sucrose, glucose, methyl cellulose, magnesium stearate,dicalcium phosphate, calcium sulfate, mannitol, sorbitol and the like.The compounds can be administered orally in solid dosage forms, such ascapsules, tablets, and powders, or in liquid dosage forms, such aselixirs, syrups, and suspensions. The active compounds can also beadministered parentally, in sterile liquid dosage forms. Buffers forachieving a physiological pH or osmolarity may also be used.

EXAMPLES Example 1 Screening for Erythrocyte-Binding Peptides with MouseErythrocytes

The PhD naïve 12 amino acid peptide phage library commercially availablefrom New England Biolabs (NEB) was used in the selection. In each roundof screening, 10¹¹ input phage were incubated with mouse erythrocytes inPBS with 50 mg/mL BSA (PBSA-50). After 1 h at 37° C., unbound phage wereremoved by centrifugation in PERCOLL (GE Life Sciences) at 1500 g for 15min. A subsequent dissociation step was carried out in PBSA-50 in orderto remove low-affinity binding phage. Dissociation duration andtemperature were increased in later rounds of screening to increasestringency of the selection process. In round 1, phage binding wasfollowed by a 2 min dissociation step at room temperature prior towashing and elution. In round 2, phage binding was followed by a 10 mindissociation at 37° C. In rounds 3 and 4, two separate and sequentialdissociation steps were conducted at 37° C.: 10 min followed by 15 minin round 3, and 10 min followed by 30 min in round 4.Erythrocyte-associated phage were eluted with 0.2 M glycine, pH 2.2 for10 min, and the solution neutralized with 0.15 volumes of 1 M Tris, pH9.1. Applying 4 rounds of selection against whole erythrocytessubstantially enriched the library towards high-affinity phage clones,as illustrated by flow cytometry. Infective or plaque forming units werecalculated by standard titering techniques. Phage samples were seriallydiluted into fresh LB media, and 10 μL of the phage dilution was addedto 200 μL of early-log phase ER2738 E. coli (NEB). Following a 3 minuteincubation at room temperature, the solution was added to 3 mL of topagar, mixed, and poured onto LB plates containing IPTG and XGal.Following incubation overnight at 37° C., blue colonies were counted asplaque forming units (pfu).

Example 2 Characterizing of Binding to Mouse Erythrocytes

Result: Microscopy confirmed that the ERY1 phage binds the erythrocytecell surface without altering cell morphology and without cytoplasmictranslocation. Fluorescence and phase contrast images reiterated theerythrocyte-binding capacity of ERY1 phage relative to the non-selectedlibrary. High-resolution confocal imaging revealed that ERY1 phage aredistributed across the cell surface (as opposed to being clustered at asingle site) and bind preferentially to the equatorial periphery of thecell surface, and that binding was homogeneous among erythrocytes (FIG.1).

Method: For all samples sample, 10¹¹ input phage were incubated withmouse erythrocytes in PBS-50. After 1 h at 37° C., unbound phage wereremoved by centrifugation at 200 g for 3 min. For regular fluorescencemicroscopy samples, cells were incubated with anti-M13 coat protein-PEantibody (Santa Cruz Biotechnology) at a 1:20 dilution in PBSA-5 for 1 hat room temperature. Cells were spun at 200 g for 3 min, resuspended in10 μL of hard-set mounting medium (VECTASHIELD), applied to a microscopeslide, covered with a cover slip, and visualized. For confocalmicroscope samples, cells were incubated with rabbit anti-fdbacteriophage (Sigma) and anti-rabbit ALEXAFLUOR conjugate (Invitrogen).

Example 3 Characterizing the Molecular Target of Binding to MouseErythrocytes

Result: To search for the molecular target for the ERY1 peptide,affinity pull-down techniques using a biotinylated soluble peptide wereemployed; this method revealed glycophorin-A (GYPA) as the ERY1 ligandon the erythrocyte membrane. When whole erythrocytes were incubated withERY1 peptide functionalized with biotin and a photoactivatablecrosslinker, a single 28 kDa protein was conjugated with thepeptide-biotin complex, as detected by a streptavidin Western blot (FIG.2A). The reaction lysate was extensively washed and purified usingstreptavidin magnetic beads to ensure no unlabeled proteins from theerythrocyte lysate remained. As expected, the mismatch peptide failed toconjugate to any erythrocyte proteins. The mismatch peptide,PLLTVGMDLWPW (SEQ ID NO:2), was designed to contain the same amino acidresidues as ERY1, and to match its hydrophobicity topography. Evidenceof the apparent size of the interacting protein suggested severalsmaller, single pass membrane proteins as likely ligands, namely theglycophorins. Anti-GYPA Western blotting of the same purified samplesfrom the crosslinking reaction confirmed that the candidate biotinlyatedprotein was indeed GYPA (FIG. 2B).

Co-localization of ERY1 phage with GYPA was analyzed by high-resolutionconfocal microscopy. GYPA is naturally expressed and presented as partof a complex comprised of several membrane and cytoskeletal proteins(Mohandas and Gallagher, 2008). This is visually evident in GYPAstaining, whereby non-uniform labeling was seen at the cell equatorialperiphery. Labeling with ERY1 phage produced extremely similar stainingtopographies. A high overlap coefficient of 0.97 in co-localizationanalysis, corroborated the conclusion that ERY1 phage and anti-GYPA bindto the same protein. GYPA clustering was also witnessed in erythrocyteslabeled with library phage, yet no phage binding thus no co-localizationwas evident.

Method: The ERY1 (H₂N-WMVLPWLPGTLDGGSGCRG-CONH₂) (SEQ ID NO:19) andmismatch (H₂N-PLLTVGMDLWPWGGSGCRG-CONH₂) (SEQ ID NO:20) peptides weresynthesized using standard solid-phase f-moc chemistry on TGR resin. Thepeptide was cleaved from the resin in 95% tri-fluoroacetic acid, 2.5%ethanedithiol, 2.5% water, and precipitated in ice-cold diethyl ether.Purification was conducted on a Waters preparative HPLC-MS using a C18reverse phase column.

The ERY1 and mismatch peptide were conjugated to Mts-Atf-biotin (ThermoScientific) as suggested by the manufacturer. In brief, peptides weresolubilized in PBS/DMF and reacted with 1.05 equivalents ofMts-atf-biotin overnight at 4° C. Following clarification of thereaction by centrifugation, biotinylated peptide was incubated witherythrocytes at in PBSA-50 for 1 h at 37° C., cells were washed twice infresh PBS, and were UV irradiated at 365 nm for 8 min at roomtemperature. Cells were lysed by sonication and the lysate was purifiedusing streptavidin-coated magnetic beads (Invitrogen). The eluate wasrun on an SDS-PAGE and transferred to a PVDF membrane, and immunoblottedwith streptavidin-HRP (R&D Systems) or anti-mouse GYPA.

Example 4 Characterizing Binding or the Lack of Binding of ERY1 to OtherMouse Cells and Erythrocytes from Other Species

Result: Flow cytometric screening of a panel of interspecies cell linesdemonstrated the ERY1 phage was specific for mouse and rat erythrocytes,with no measurable binding to mouse leukocytes or human cells (FIG. 3).These data suggested that the specific membrane protein acting as theERY1 ligand was found solely in erythroid cells, and not in myeloid orlymphoid cell lineages. Furthermore, this validated the screening methodof using freshly isolated blood with little prior purification otherthan centrifugation for a target.

Method: To determine phage binding, approximately 10¹⁰ phage particleswere used to label 5×10⁵ cells in PBSA-50 for 1 h at 37° C. Following a4-min centrifugation at 200 g, cells were resuspended in PBSA-5 andanti-phage-PE was added at a 1:20 dilution for 1 h at room temperature.After a final spin/wash cycle, cells were resuspended in PBSA-5 andanalyzed on a flow cytometer.

Example 5 Characterizing Intravascular Pharmacokinetics with a ModelProtein

Result: To characterize the effect of the ERY1 peptide upon thepharmacokinetics of a protein, we expressed the model protein maltosebinding protein (MBP) as an N-terminal fusion with the ERY1 peptide(ERY1-MBP). Upon intravascular administration, the ERY1-MBP variantexhibited extended circulation relative to the wild-type protein (FIG.4). Blood samples at time points taken immediately following injectionconfirmed that initial concentrations, and thus the dose, were identicalin both formulations. Beginning 4 h after intravenous injection,ERY1-MBP was cleared from circulation at a statistically significantslower rate than the non-binding wild-type MBP.

ERY1-MBP demonstrated a 3.28 (for a single-compartment model) to 6.39fold (for a two-compartment model) increase in serum half-life and a2.14 fold decrease in clearance as compared to the wild-type MBP.Analyzing concentrations using a standard one-compartmentpharmacokinetic model yielded a half-life of 0.92 h and 3.02 h for thewild-type and ERY1 variants, respectively. The data were also accuratelyfit to a two-compartment model (R²≥0.98) to obtain α and β half lives of0.41 h and 1.11 h, and 2.62 h and 3.17 h, for the wild-type and ERY1variants, respectively. Accordingly, a half-life extension with humanerythrocyte binding peptides and other erythrocyte binding ligands astaught herein may be expected.

Method: Clonal replicative form M13KE DNA was extracted using a standardplasmid isolation kit. The resultant plasmid was digested with Acc651and EagI to obtain the gIII fusion gene and then ligated into the samesites in pMAL-pIII, yielding the plasmid herein termed pMAL-ERY1.Sequence verified clones were expressed in BL21 E. coli. In brief,mid-log BL21 cultures were induced with IPTG to a final concentration of0.3 mM for 3 h at 37° C. An osmotic shock treatment with 20 mM Tris, 20%sucrose, 2 mM EDTA for 10 min, followed by a second treatment in 5 mMMgSO₄ for 15 min at 4° C., allowed for the periplasmically expressed MBPfusion to be isolated from the cell debris. Purification of the fusionprotein was conducted on amylose SEPHAROSE and analyzed for purity bySDS-PAGE.

The Swiss Vaud Veterinary Office previously approved all animalprocedures. While under anesthesia with ketamine/xylasine, the mousetail was warmed in 42° C. water and 150 μg of protein was injected in a100 μL volume directly into the tail vein. Care was taken to ensure micewere kept at 37° C. while under anesthesia. Blood was drawn by a smallscalpel incision on the base of the tail, and diluted 10-fold in PBSA-5,10 mM EDTA, and stored at −20° C. until further analysis. Blood sampleswere analyzed for MBP concentration by sandwich ELISA. In brief,monoclonal mouse anti-MBP was used as the capture antibody, polyclonalrabbit anti-MBP as the primary antibody, and goat anti-rabbit-HRP as thesecondary antibody. The data were analyzed in PRISM4 using standardpharmacokinetic compartmental analysis, using Eq. 1 and Eq. 2

Equation 1: Standard one-compartment model

A=A ₀ e ^(−Kt)

where A is the amount of free drug in the body at time t and A₀ is theinitial amount of drug at time zero.

Equation 2: Standard two-compartment model

A=ae ^(−αt) +be ^(−βt)

where A is the amount of free drug in the central compartment at time t.

Example 6 Characterizing Subcutaneous Pharmacokinetics with a ModelProtein

Result: Upon extravascular administration, the ERY1-MBP variantexhibited extended circulation relative to the wild-type protein (FIG.5). Blood samples at time points taken immediately following injectionconfirmed that initial concentrations, and thus the dose, were identicalin both formulations. Following subcutaneous injection, similar trendsof heightened blood concentrations of ERY1-MBP were seen sustainedthroughout the experimental duration. Analyzing blood concentrationsrevealed that the ERY1-MBP variant demonstrated a 1.67 increase inbioavailability as compared to wild-type MBP. Accordingly, half-lifeextension is possible with human erythrocyte binding peptides and othererythrocyte binding ligands as taught herein.

Method: Clonal replicative form M13KE DNA was extracted using a standardplasmid isolation kit. The resultant plasmid was digested with Acc651and EagI to obtain the gIII fusion gene and then ligated into the samesites in pMAL-pIII, yielding the plasmid herein termed pMAL-ERY1.Sequence verified clones were expressed in BL21 E. coli. In brief,mid-log BL21 cultures were induced with IPTG to a final concentration of0.3 mM for 3 h at 37° C. An osmotic shock treatment with 20 mM Tris, 20%sucrose, 2 mM EDTA for 10 min, followed by a second treatment in 5 mMMgSO4 for 15 min at 4° C., allowed for the periplasmically expressed MBPfusion to be isolated from the cell debris. Purification of the fusionprotein was conducted on amylose Sepharose and analyzed for purity bySDS-PAGE.

The Swiss Vaud Veterinary Office previously approved all animalprocedures. While under anesthesia with isoflurane, 150 μg of proteinwas injected in a 100 μL volume directly into the back skin of mice.Care was taken to ensure mice were kept at 37° C. while underanesthesia. Blood was drawn by a small scalpel incision on the base ofthe tail, and diluted 10-fold in PBSA-5, 10 mM EDTA, and stored at −20Cuntil further analysis. Blood samples were analyzed for MBPconcentration by sandwich ELISA. In brief, monoclonal mouse anti-MBP wasused as the capture antibody, polyclonal rabbit anti-MBP as the primaryantibody, and goat anti-rabbit-HRP as the secondary antibody. The datawere analyzed in Prism4 using standard pharmacokinetic compartmentalanalysis, using Eq. 3.

$\begin{matrix}{{Bioavailability}{B = \frac{{AUC}_{\infty}^{s.c.}}{{AUC}_{\infty}^{i.v.}}}} & {{Equation}\mspace{14mu} 3}\end{matrix}$

where AUC is the area under the curve of the plasma concentration vs.time graph, s.c. is subcutaneous and i.v. is intravenous.

Example 7 Engineering the Linker Domain of scFv Antibodies

Method: The gene encoding for the scFv fragment against the extra domainA of fibronectin was ordered synthesized from DNA 2.0 (Menlo Park,Calif., USA):

5′ATGGCAAGCATGACCGGTGGCCAACAAATGGGTACGGAAGTGCAACTGCTGGAGTCTGGCGGTGGCCTGGTTCAGCCGGGTGGCAGCTTGCGCCTGAGCTGTGCGGCGTCTGGCTTCACCTTTAGCGTCATGAAAATGAGCTGGGTTCGCCAGGCACCAGGTAAAGGCCTGGAGTGGGTGTCGGCAATCAGCGGTTCCGGTGGTAGCACCTATTACGCTGACAGCGTGAAAGGCCGTTTTACGATTTCGCGTGATAACAGCAAGAACACGCTGTACTTGCAAATGAATAGCCTGCGTGCAGAGGACACGGCAGTGTACTATTGTGCGAAGAGCACTCACCTGTACTTGTTTGATTACTGGGGTCAAGGCACCCTGGTTACCGTTAGCAGCGGCGGTGGTGGCTCCGGTGGTGGTGGTAGCGGTGGCGGTGGTTCTGGTGGTGGCGGCTCTGAAATTGTCCTGACTCAGAGCCCTGGCACGCTGAGCCTGAGCCCGGGTGAGCGCGCGACGCTGAGCTGCCGTGCGAGCCAGTCCGTTAGCAACGCGTTCCTGGCTTGGTATCAACAGAAACCGGGTCAGGCCCCTCGCCTGCTGATTTACGGTGCCAGCTCCCGTGCGACGGGCATCCCGGACCGTTTTTCCGGCTCCGGTAGCGGCACCGACTTCACCCTGACCATCAGCCGCCTGGAGCCGGAGGATTTCGCGGTGTATTACTGCCAGCAAATGCGTGGCCGTCCGCCGACCTTCGGTCAGGGTACCAAGGTCGAGATTAAGGCTGCGGCCGAACAGAAACTGATCAGCGAAGAAGATTTGAATGGTGCCGCG-3′ (SEQ ID NO:21). For construction of anexpression plasmid containing the wild-type scFv, primers SK01 and SK02were used to PCR amplify the gene and add HindIII (5′ end) and XhoI (3′end) restriction sites, as well as two stop codons at the 3′ end. Forconstruction of the REP mutant scFv containing the ERY1 peptide in thelinker region of the scFv, overlap extension PCR was used. Using primersSK01 and SK03, a gene fragment comprising of the 5′ half of the scFvfollowed by an ERY1 gene fragment was created by PCR. Using primers SK02and SK04, a gene fragment comprising of an ERY1 gene fragment(complimentary to the aforementioned fragment) followed by the 3′ halfof the scFv was created by PCR. The gene fragments were purifiedfollowing agarose electrophoresis using a standard kit (Zymo Research,Orange, Calif., USA), and the two fragments were fused using PCR. Afinal amplification PCR using SK01 and SK02 primers was conducted tocreate the correct restriction sites and stop codons. Construction ofthe INS mutant scFv was conducted in exactly the same manner as the REPmutant, except primer SK05 was used in place of SK03, and SK06 was usedin place of SK04. Each final completed scFv gene product was digestedwith HindIII and XhoI (NEB, Ipswich, Mass., USA), and ligated into thesame sites on the pSecTagA mammalian expression plasmid (Invitrogen,Carlsbad, Calif., USA).

SEQ ID Primer NO name Primer sequence (5 to 3′) SEQ ID  SK01TCTAAGCTTGATGGCAAGCATGACCGGTGG NO: 22 SEQ ID  SK02TCGCTCGAGTCATCACGCGGCACCATTCAAATCTT NO: 23 SEQ ID  SK03CAACGTACCAGGCAGCCACGGAAGCACCATCCAGC NO: 24 TACCACCACCACCGGAGCCA SEQ ID SK04 GTGCTTCCGTGGCTGCCTGGTACGTTGGATGGTGG NO: 25 CGGTGGTTCTGGTGGTGSEQ ID  SK05 ACGTACCAGGCAGCCACGGAAGCACCATCCAACCA NO: 26CCGGAGCCGCTGCTAACGGTAACCAGGGTG SEQ ID  SK06GGTGCTTCCGTGGCTGCCTGGTACGTTGGATGGTG NO: 27GCTCTGGTGAAATTGTCCTGACTCAGAGCC

Sequence verified clones were amplified and their plasmid DNA purifiedfor expression in human embryonic kidney (HEK) 293T cells. Theexpression plasmid contains an N-terminal signal sequence for secretionof the recombinant protein of interest into the media. Following 7 daysof expression, cells were pelleted, the media harvested, and scFv waspurified using size exclusion chromatography on a SUPERDEX 75 column (GELife Sciences, Piscataway, N.J., USA).

The ERY1 peptide containing a C-terminal cysteine was conjugated to thewild type scFv usingsuccinimidyl-4-(N-maleimidomethyl)cyclohexane-1-carboxylate (SMCC, CAS#64987-85-5, Thermo Scientific) as a crosslinker. SMCC was dissolved indimethyl formamide and added to the scFv in phosphate buffered saline(PBS) at a 30-fold molar excess. Following 2 h at 4° C., the reactionwas desalted on a ZEBASPIN desalting column (Thermo Scientific), and theproduct was reacted with ERY1 peptide at a 5 molar excess of peptide.Following 2 h at 4° C., the reaction was dialyzed against PBS in 10 kDaMWCO dialysis tubing for 2 days at 4° C. The conjugated scFv wasanalyzed by SDS-PAGE, Western blotting, and MALDI.

Example 8 Screening for Erythrocyte-Binding Peptides with HumanErythrocytes

Result: For the selection of seven novel peptides binding to humanerythrocytes, an E. coli surface display library was employed. Thescreening process was performed in washed whole blood in a highconcentration of serum albumin (50 mg/mL) and at 4° C. to reducenon-specific binding to leukocytes. The peptide library was initiallyenriched in 3 rounds through incubation with blood followed by carefulseparation of erythrocytes with bacteria bound from other cells throughextensive washing and density gradient centrifugation. Subsequently,bacterial plasmids encoding for the selected peptides were transformedinto bacteria expressing a green fluorescent protein variant. Thisallowed for green bacteria bound to erythrocytes to be sorted by highthroughput FACS, and individual bacterial clones recovered were assayedfor binding to erythrocytes using cytometry. Seven uniqueerythrocyte-binding peptides were identified, as shown in Table 1. Thesepeptides did not contain consensus motifs nor were relevant proteinsequence homologies found when analyzing against known proteins usingthe BLAST algorithm in UniProt.

Method: The E. coli surface display was comprised of over a billiondifferent bacteria, each displaying approximately 1000 copies of arandom 15 mer peptide on the N-terminus of a scaffold protein, eCPX, acircularly permuted variant of outer membrane protein X (Rice andDaugherty, 2008). For the first three cycles of selection, bacteriabinding to human erythrocytes were selected using co-sedimentation,followed by one round of FACS (Dane, Chan, et al., 2006). Frozenaliquots of 10¹¹ cells containing the eCPX surface display library werethawed and grown overnight in Luria Bertani (LB) broth supplemented with34 μg/mL chloramphenicol (Cm) and 0.2% D-(+)- glucose at 37° C. Thebacteria were subcultured 1:50 for 3 h in LB supplemented with Cm andinduced with 0.02% L- (+)-arabinose for 1 h. Human blood (type B) from ahealthy donor was washed twice with 5% HSA, 2% FBS in PBS (HFS),resuspended in conical tubes, and co-incubated with 10¹¹ bacterial cellsfor 1 h on an inversion shaker at 4° C. Cell suspensions werecentrifuged at 500 g for 5 min and non-binding bacteria in thesupernatant were removed. Erythrocytes were washed three times in 50 mLHFS and resuspended in LB for overnight growth of binding bacteria.Recovered bacterial clones were counted by plating on LB-agar platessupplemented with Cm. For the second and third rounds, 10⁸ and 5×10⁷bacteria were added, respectively, and washed once as above,erythrocytes were separated using a 70% Percoll (GE Life Sciences)gradient at 1000 g for 10 min. For flow cytometric sorting, plasmids ofthe selected eCPX library populations were extracted from bacterialcells using Zyppy Miniprep kits. Subsequently, these plasmids weretransformed into E. coli MC1061/pLAC22Grn1 for inducible GFP expression.GFP expression was induced with 1 mM IPTG for 2 h followed by inductionof peptide surface expression with 0.02% L- (+)-arabinose for 1 h, bothat 37° C. Sample preparation for FACS was performed using similartechniques as described above and the fluorescent round three populationbinding to erythrocytes was sorted using a FACSAria (BD Biosciences).

Example 9 Characterizing of Binding to Human Erythrocytes

Result: To characterize the selected peptides that bound to humanerythrocytes, bacteria displaying each individual peptide were subjectedto binding assays with multiple cell types. Six (ERY19, ERY59, ERY64,ERY123, ERY141 and ERY162) of seven peptides bound specifically to humanerythrocytes as compared to binding towards human epithelial 293T cellsand human endothelial HUVECs (FIG. 7A). Additionally, peptides bound tohuman blood types A and B, but not to mouse blood (FIG. 7B) indicatingthat these peptides were specific to human blood, but not dependent onthe common blood group antigens. Peptides are synthesized using standardsolid-phase f-moc chemistry, conjugated to nanoparticles, and analyzedfor binding to individual cell types as above. Binding to erythrocytesurfaces is studied using both microscopy and flow cytometry.

Method: To characterize specificity, individual sequenced clones wereanalyzed using cytometry for binding toward human erythrocytes (type Aand B), mouse erythrocytes, HEK293T cells and HUVECs. For bindingassays, 10⁶ mammalian cells were scanned on an AccuriA6 afterco-incubation with 5×10⁷ bacteria for 1 h at 4° C. followed by threewashes in HFS (5% HSA, 2% FBS in PBS). The percentage of cells withgreen bacteria bound was calculated using FLOWJO Software.

Example 10 Engineering the Linker Domain of scFv Antibodies

Engineered scFvs against the tumor vascular marker fibronectin EDA (EDA)may be created as fusions to the peptides that bind specifically tohuman erythrocytes. A plurality of, or each, peptide from Example 8 isto be inserted in to the (GGGGS)₄ (SEQ ID NO:18) linker region, orcomparable region, similar to the two ERY1 containing mutants that weredesigned; as such, peptides ERY19, ERY50, ERY59, ERY64, ERY123, ERY141,ERY162 will be added in place of ERY1 in the sequences in the REP andINS mutants (FIG. 6A). As the human ERY peptides were discoveredtethered to the N-terminus of the scaffold protein eCPX, theseconstructs inserted into a linker region may affect erythrocyte binding.To address this, scFv variants are to be created by chemical conjugationwith synthetic human ERY peptides, similar to ERY1 (FIG. 6C). This willallow for the optimum number of ERY peptides, alone or in combination,to be added to the scFv to stimulate erythrocyte binding.

Example 11 Characterizing Pharmacokinetics and Biodistribution ofPolymeric Nanoparticles and Micelles

The inventive laboratory has previously developed numerous polymer-basednanoparticles and micelles for use in drug delivery andimmunomodulation. This technology is robust in that it allows for facilesite-specific conjugation of thiol-containing molecules to thenanoparticle in a quantifiable manner (van der Vlies, O'Neil, et al.,2010). This laboratory has also developed micelle formulationsdisplaying multiple chemical groups on a single micelle, andformulations capable of controlled delivery of hydrophobic drugs(O'Neil, van der Vlies, et al., 2009; Velluto, Demurtas, et al., 2008).This laboratory has also explored the use of its nanoparticle technologyas a modulator of the immune response, as they target antigen presentingcells in the lymph node (Reddy, Rehor, et al., 2006; Reddy, van derVlies, et al., 2007). Micellar and particle technologies for combinationwith materials and methods herein include US 2008/0031899, US2010/0055189, and US 2010/0003338, which are hereby incorporated byreference herein.

Adding the ERY1 peptide or human erythrocyte binding peptides to thesenanoparticle and micelle platforms improves their pharmacokineticbehavior, thereby enhancing their performance as circulating drugcarriers. ERY1 or human erythrocyte binding peptide conjugation to anyvariant of nanoparticle or micelle may be performed by various reactionschemes, and conjugation of a detection molecule to the end product maybe accomplished using an orthogonal chemistry. Validation ofnanoparticle or micelle binding to erythrocytes, due to presence of theERY1 or human erythrocyte binding peptide group, can be verified by flowcytometry and microscopy, and further validation by in vivocharacterization may be performed by quantifying the detection moleculeat varying time points following administration in mice.

Example 12 Engineering Polymer Nanoparticles and Micelles for Occlusionof Tumor Vasculature

Engineered polymer nanoparticles and micelles, designed for dualspecificity for both erythrocytes and a tumor vascular marker may beprepared that cause an aggregation event of erythrocytes in the tumorvascular bed and specifically occlude its blood supply. Severaltumor-targeting markers can be evaluated and utilized, includingmodified scFv's for fibronectin EDA that include a cysteine in thelinker region, a fibrinogen binding peptide containing the GPRP peptidemotif, and a truncated tissue factor fusion protein, each with either anengineered cysteine or biotin to allow for attachment to particles.These tumor targeting ligands may be put in combination with theerythrocyte-binding peptides or glycophorin A scFvs on nanoparticles andmicelles at optimum ratios to achieve dual targeting; multiple ligandsmay be attached to particles through disulfide linkages or avidin-biotininteractions. By way of verification, a standard mouse solid tumor modelcould be employed whereby mouse tumor cells are injected into the backskin of mice, and allowed to grow a predetermined period of time, atwhich point the mice would be administered with nanoparticles ormicelles. Dosage and treatment regimens may be determined followingcharacterization of the pharmacokinetics of the therapeutics. Forfurther verification, at varying time points following treatment, tumorvolume could be compared between treatment groups to assess thetherapeutic's potential to block further growth of the tumor mass.Further confirmation of erythrocyte-mediated blockage of the tumorvasculature could be assessed by perfusion experiments in livetumor-bearing mice. A positive correlation between the therapeutic'saffinity for erythrocytes and tumor vascular occlusion would beobserved.

Example 13 Engineering scFv Antibodies for Occlusion of TumorVasculature

Engineered scFvs specific for the tumor vascular marker EDA and forerythrocytes can cause an aggregation event of erythrocytes in the tumorvascular bed and specifically occlude its blood supply. The modifiedscFv's for EDA includes the human ERY binding peptides as fusions in thelinker region or as conjugates to the scFv. A standard mouse solid tumormodel may be employed whereby mouse tumor cells are injected into theback skin of mice, allowed to grow a predetermined period of time, atwhich point the mice are administered with nanoparticles or micelles.Dosage and treatment regimens are to be determined followingcharacterization of the pharmacokinetics of the therapeutics. At varyingtime points following treatment, tumor volume may be compared betweentreatment groups to assess the therapeutic's potential to block furthergrowth of the tumor mass. Confirmation of erythrocyte-mediated blockageof the tumor vasculature may be assessed by perfusion experiments inlive tumor-bearing mice. The therapeutic's affinity for erythrocyteswill correlate to tumor vascular occlusion.

Example 14 Inducing Antigen-Specific Immunological Tolerance ThroughNon-Covalent Erythrocyte-Binding with ERY1 Peptide-Conjugated Antigen orHuman Erythrocyte Binding Peptide-Conjugated Antigen

To obtain strong and specific biophysical binding of an antigen toerythrocytes, we used a synthetic 12 amino acid peptide (ERY1) that wediscovered by phage display to specifically bind to mouse glycophorin-A(Kontos and Hubbell, 2010). In this investigation, the model antigen OVAwas used with a transgenic mouse strain (OT-I) whose CD8⁺ T cellpopulation expresses the T cell receptor specific for the MHC Iimmunodominant OVA peptide SIINFEKL (SEQ ID NO:3). The ERY1 peptide waschemically conjugated to OVA to create an OVA variant (ERY1-OVA) thatbinds mouse erythrocytes with high affinity and specificity (FIG. 8a ).High-resolution confocal microscopy confirmed earlier observationsconcerning ERY1 binding (Kontos and Hubbell, 2010), namely localizationto the cell membrane equatorial periphery, with no intracellulartranslocation of the ERY1-conjugated protein. ERY1-mediated binding toglycophorin-A was sequence-specific, as an OVA variant conjugated with amismatch peptide (MIS-OVA), containing identical amino acids to ERY1 butscrambled in primary sequence, displayed negligible binding (FIG. 8b ).OVA conjugated with only the crosslinking molecule used to conjugate thepeptide did not display any measureable affinity towards erythrocytes,confirming that ERY1-OVA binding resulted from non-covalent interactionbetween the ERY1 peptide and glycophorin-A on the erythrocyte surface.Furthermore, ERY1-OVA bound to erythrocytes with high affinity,exhibiting an antibody-like dissociation constant (Ka) of 6.2±1.3 nM, asdetermined by equilibrium binding measurements (FIG. 8c ).

ERY1-OVA binding was validated in vivo to circulating erythrocytesfollowing intravenous administration in mice. Whole blood samples taken30 min following injection of 150 μg of either OVA or ERY1-OVA confirmedthe specific erythrocyte-binding capability of ERY1-OVA even amidst thecomplex heterogeneous milieu of blood and the vasculature (FIG. 9a ).Consistent with glycophorin-A association, ERY1-OVA bound toerythrocytes (CD45⁻) but not to leukocytes (CD45⁺). ERY1-OVA binding wasunbiased as to the apoptotic state of the erythrocytes, binding stronglyto both annexin-V⁺ and annexin-V⁻ CD45⁻ populations (FIG. 9b ).Pharmacokinetic studies of the OVA conjugate demonstrated that ERY1-OVAerythrocyte binding was long-lived in vivo, exhibiting a cell-surfacehalf-life of 17.2 h (FIG. 9c ). ERY1-OVA remained bound to erythrocytesfor as long as 72 h following administration; during this time frame,approximately 13% of erythrocytes are cleared in the mouse (Khandelwaland Saxena, 2006). Quantification of erythrocyte-bound ERY1-OVA in vivoshowed a relatively high loading of 0.174±0.005 ng of OVA per 10⁶erythrocytes.

To exclude any potential physiological effects of OVA loading onerythrocyte function, hematological parameters were characterized atvarying time points following intravenous administration of eitherERY1-OVA or OVA. Erythrocyte binding by ERY1-OVA elicited no detectabledifferences in hematocrit, corpuscular volume, or erythrocyte hemoglobincontent, as compared with administration of OVA (FIG. 10). These resultsdemonstrate that glycophorin-A-mediated erythrocyte binding with antigendid not alter their hematological parameters.

To reveal the cellular targets of erythrocyte-bound antigen uponadministration, mice were intravenously injected with the highlyfluorescent allophycocyanin protein, conjugated to either ERY1(ERY1-allophycocyanin) or MIS peptide (MIS-allophycocyanin). Flowcytometric analysis of splenic DC populations 12 and 36 h followingadministration showed 9.4-fold enhanced uptake of ERY1-allophycocyaninby MHCII⁺ CD11b⁻ CD11c⁺ DCs as compared with MIS-allophycocyanin, yetsimilar uptake of ERY1-allophycocyanin and MIS-allophycocyanin by MHCII⁺CD11b⁺ CD11c⁺ DCs (FIG. 11a ). Additionally, MHCII⁺ CD8α⁺ CD11c⁺ CD205⁺splenic DCs were found to uptake ERY1-allophycocyanin to a 3.0-foldgreater extent than MIS-allophycocyanin, though the absolute magnitudewas markedly lower than for other DC populations in the spleen. Suchtargeting of antigen towards non-activated and CD8α⁺ CD205⁺ splenic DCscould strengthen the tolerogenic potential of erythrocyte binding, asthese populations have been extensively implicated in apoptoticcell-driven tolerogenesis (Ferguson, Choi, et al., 2011; Yamazaki,Dudziak, et al., 2008). In the liver, ERY1-allophycocyanin also greatlyenhanced uptake by hepatocytes (CD45⁻ MHCII⁻ CD1d⁻; by 78.4-fold) andhepatic stellate cells (CD45⁻ MHCII⁺ CD1d⁺; by 60.6-fold) as comparedwith MIS-allophycocyanin (FIG. 11b ); both populations have beenreported as antigen-presenting cells that trigger CD8⁺ T cell deletionaltolerance (Holz, Warren, et al., 2010; Ichikawa, Mucida, et al., 2011;Thomson and Knolle, 2010). Interestingly, such uptake was not seen inliver DCs (CD45⁻ CD11c⁺) or Kupffer cells (CD45⁺ MHCII⁺ F4/80⁺), whichserve as members of the reticuloendothelial system that aid in clearanceof erythrocytes and complement-coated particles. Increased uptake oferythrocyte-bound antigen by the tolerogenic splenic DC and liver cellpopulations suggests the potential for a complex interconnectedmechanism of antigen-specific T cell deletion driven by non-lymphoidliver cell and canonical splenic cell cross-talk.

Erythrocyte binding of ERY1-OVA was observed to lead to efficientcross-presentation of the OVA immunodominant MHC I epitope (SIINFEKL)(SEQ ID NO:3) by APCs and corresponding cross-priming of reactive Tcells. CFSE-labeled OT-I CD8⁺ T cells (CD45.2⁺ were adoptivelytransferred into CD45.1⁺ mice. Measurements were made of theproliferation of the OT-I CD8⁺ T cells over 5 d following intravenousadministration of 10 μg of OVA, 10 μg ERY1-OVA, or 10 μg of anirrelevant erythrocyte-binding antigen, ERY1-glutathione-S-transferase(ERY1-GST). OT-I CD8⁺ T cell proliferation, determined by dilution ofthe fluor CFSE as measured by flow cytometry (FIG. 12a ), was markedlyenhanced in mice administered ERY1-OVA compared to OVA (FIG. 12b ),demonstrating that erythrocyte-binding increased antigen-specific CD8⁺ Tcell cross-priming compared to the soluble antigen. Similar results werealso obtained by administration of a 10-fold lower antigen dose of 1 μg,demonstrating the wide dynamic range of efficacy of OT-I CD8⁺ T cellproliferation induced by erythrocyte-bound antigen. The results oncross-presentation and cross-priming are consistent with other studiesconcerning tolerogenic antigen presentation on MHC I by APCs engulfingantigen from apoptotic cells (Albert, Pearce, et al., 1998; Green,Ferguson, et al., 2009).

To distinguish T cells being expanded into a functional effectorphenotype from those being expanded and deleted, the proliferating OT-ICD8⁺ T cells for annexin-V were analyzed as a hallmark of apoptosis andthus deletion (FIG. 12c ). ERY1-OVA induced much higher numbers ofannexin-V⁺ proliferating OT-I CD8⁺ T cells than OVA (FIG. 12d ),suggesting an apoptotic fate that would eventually lead to clonaldeletion. The same proliferating OT-I CD8⁺ T cells induced by ERY1-OVAadministration exhibited an antigen-experienced phenotype at both 1 and10 μg doses, displaying upregulated CD44 and downregulated CD62L (FIG.13). This phenotype of proliferating CD8⁺ T cells is consistent withother reported OT-I adoptive transfer models in which regulatedantigen-specific T cell receptor engagement by APCs fails to induceinflammatory responses (Bursch, Rich, et al., 2009).

Using an established OT-I challenge-to-tolerance model (Liu, Iyoda, etal., 2002) (FIG. 14a ), ERY1-OVA was demonstrated to prevent subsequentimmune responses to vaccine-mediated antigen challenge, even with a verystrong bacterially-derived adjuvant. To tolerize, we intravenouslyadministered 10 μg of either OVA or ERY1-OVA 1 and 6 d followingadoptive transfer of OT-I CD8⁺ (CD45.2⁺) T cells to CD45.1⁺ mice. After9 additional days to allow potential deletion of the transferred Tcells, we then challenged the recipient mice with OVA adjuvanted withlipopolysaccharide (LPS) by intradermal injection. Characterization ofdraining lymph node and spleen cells as well as their inflammatoryresponses 4 d after challenge allowed us to determine if deletionactually took place.

Intravenous administration of ERY1-OVA resulted in profound reductionsin OT-I CD8⁺ T cell populations in the draining lymph nodes (FIG. 14;gating in FIG. 14b ) and spleens compared with mice administeredunmodified OVA prior to antigen challenge with LPS (FIG. 14c ),demonstrating deletional tolerance. Draining lymph nodes fromERY1-OVA-treated mice contained over 11-fold fewer OT-I CD8⁺ T cells ascompared to OVA-treated mice, and 39-fold fewer than challenge controlmice that did not receive intravenous injections of antigen; responsesin spleen cells were similar. This effective clonal deletion exhibitedin mice administered ERY1-OVA supported earlier observations of enhancedOT-I CD8⁺ T cell cross-priming (FIG. 12) and furthermore shows thatcross-priming occurred in the absence of APC presentation ofco-stimulatory molecules to lead to deletional tolerance.

To further evaluate the immune response following antigen challenge, theinflammatory nature of resident lymph node and spleen cells wascharacterized by expression of interferon-γ (IFNγ) by OT-I CD8⁺ T cells(FIG. 14d ). Following challenge with OVA and LPS, the lymph nodes ofmice previously treated with ERY1-OVA harbored 53-fold fewerIFNγ-expressing cells compared to challenge control mice (previouslyreceiving no antigen), and over 19-fold fewer IFNγ-expressing cellscompared to mice previously treated with an equivalent dose of OVA (FIG.14e ), demonstrating the importance of erythrocyte binding intolerogenic protection to challenge; responses in spleen cells weresimilar. In addition, of the small OT-I CD8⁺ T cell population presentin the lymph nodes and spleens of mice previously treated with ERY1-OVA,a lower percentage expressed IFNγ, suggesting clonal inactivation.Furthermore, the magnitude of total IFNγ levels produced by cellsisolated from the draining lymph nodes upon SIINFEKL restimulation wassubstantially reduced in mice previously treated with ERY1-OVA (FIG. 14f), erythrocyte binding reducing IFNγ levels 16-fold compared to OVAadministration and over 115-fold compared to challenge controls. Ofnote, the suppressive phenomenon was also correlated with downregulatedinterleukin-10 (IL-10) expression, as lymph node cells from micepreviously treated with ERY1-OVA expressed 38% and 50% less IL-10 ascompared with previously OVA-treated and challenge control mice,respectively (FIG. 14g ). Typically considered a regulatory CD4⁺ Tcell-expressed cytokine in the context of APC-T cell communication todampen Th1 responses (Darrah, Hegde, et al., 2010; Lee and Kim, 2007),IL-10 expression was dispensible for desensitization to challenge.Similar IL-10 downregulation has been implicated in CD8⁺ T cell mediatedtolerogenesis (Fife, Guleria, et al., 2006; Arnaboldi, Roth-Walter, etal., 2009; Saint-Lu, Tourdot, et al., 2009). Erythrocyte-binding alsosubstantially attenuated humoral immune responses against antigen, asmice treated with ERY1-OVA exhibited 100-fold lower antigen-specificserum IgG titers compared with mice treated with soluble OVA (FIG. 14h). A similar reduction in OVA-specific IgG titer reduction as a resultof erythrocyte binding was seen in non-adoptively transferred C57BL/6(CD45.2⁺) mice. Following two intravenous administrations of 1 μg OVA orERY1-OVA 7 d apart, ERY1-OVA treated mice exhibited 39.8-fold lowerOVA-specific serum IgG levels 19 d after the first antigenadministration (FIG. 15). This apparent reduction in B cell activation,following erythrocyte ligation by the antigen, corroborates currenthypotheses concerning non-inflammatory antigen presentation duringtolerance induction (Miller, Turley, et al., 2007; Green, Ferguson, etal., 2009; Mueller, 2010).

To further validate the induction of antigen-specific immune tolerance,the OT-I challenge-to-tolerance model was combined with anOVA-expressing tumor graft model (FIG. 14i ). Similar to the previousexperimental design, mice were tolerized by two intravenousadministrations of 10 μg ERY1-OVA or 10 μg OVA following adoptivetransfer of OT-I CD8⁺ T cells. Marked T cell deletion was detected 5 dfollowing the first antigen administration, as ERY1-OVA injected miceharbored 2.9-fold fewer non-proliferating (generation 0) OT-I CD8⁺ Tcells in the blood (FIG. 14j ). To determine the functionalresponsiveness of proliferating OT-I CD8⁺ T cells in the absence of astrong exogenously administered adjuvant, OVA-expressing EL-4 thymomacells (E.G7-OVA) were intradermally injected into the back skin of mice9 d following adoptive transfer. To assess the tolerogenic efficacy oferythrocyte-bound antigen, tumor-bearing mice were challenged withLPS-adjuvanted OVA 6 d following tumor grafting, analogous in dose andschedule to the challenge-to-tolerance model. Robust tumor growth wascontinuously observed in ERY1-OVA treated mice as compared toOVA-treated or non-treated control mice through to 8 d following tumorgrafting (FIG. 14k ), confirming that ERY1-OVA driven OT-I CD8⁺ T cellproliferation induced functional immune non-responsiveness to OVA. Thattumor size was arrested to a steady state 8 d following grafting may beindicative of residual OT-I CD8⁺ T cells that had yet to undergoERY1-OVA-driven deletional tolerance.

Animals

Swiss Veterinary authorities previously approved all animal procedures.8-12 wk old female C57BL/6 mice (Charles River) were used for in vivobinding studies and as E.G7-OVA tumor hosts. C57BL/6-Tg(TcraTcrb) 1100Mjb (OT-I) mice (Jackson Labs) were bred at the EPFL Animal Facility,and females were used for splenocyte isolation at 6-12 wk old. 8-12 weekold female B6.SJL-Ptprc^(a)Pepc^(b)/Boy (CD45.1) mice (Charles River)were used as recipient hosts for OT-I CD8⁺ T cell adoptive transfer andtolerance induction studies.

Peptide Design and Synthesis

(SEQ ID NO: 19) The ERY1 (H₂N-WMVLPWLPGTLDGGSGCRG-CONH₂)and mismatch (H₂N-PLLTVGMDLWPWGGSGCRG-CONH₂) (SEQ ID NO:20) peptideswere synthesized using standard solid-phase f-moc chemistry using TGRresin (Nova Biochem) on an automated liquid handler (CHEMSPEED). Theunderlined sequence is the ERY1 12-mer sequence that we previouslydiscovered by phage display as a mouse glycophorin-A binder (Kontos andHubbell, 2010). The GGSG region served as a linker to the cysteineresidue used for conjugation; the flanking arginine residue served tolower the pKa and thus increase the reactivity of the cysteine residue(Lutolf, Tirelli, et al., 2001). The peptide was cleaved from the resinfor 3 h in 95% tri-fluoroacetic acid, 2.5% ethanedithiol, 2.5% water,and precipitated in ice-cold diethyl ether. Purification was conductedon a preparative HPLC-MS (Waters) using a C18 reverse phase column(PerSpective Biosystems).

ERY1-Antigen Conjugation

10 molar equivalents ofsuccinimidyl-4-(N-maleimidomethyl)cyclohexane-1-carboxylate (SMCC, CAS#64987-85-5, Thermo Scientific) dissolved in dimethylformamide werereacted with 5 mg/mL endotoxin-free (<1 EU/mg) OVA (Hyglos GmbH) in PBSfor 1 h at room temperature. Following desalting on a 2 mL ZEBA Desaltspin column (Thermo Scientific), 10 equivalents of ERY1 or MIS peptidedissolved in 3 M guanidine-HCl were added and allowed to react for 2 hat room temperature. The conjugate was desalted using 2 mL ZEBA Desaltspin columns, 0.2 μm sterile filtered, dispensed into working aliquots,and stored at −20 C. Protein concentration was determined via BCA Assay(Thermo Scientific). The scheme results in conjugation of the cysteineside chain on the peptide to lysine side-chains on the antigen.Glutathione-S-transferase (GST) was expressed in BL21 Escherichia coliand purified using standard glutathione affinity chromatography.On-column endotoxin-removal was performed by extensive Triton-X114(Sigma Aldrich) washing, and endotoxin removal was confirmed with THP-1XBlue cells (InvivoGen). The same reaction procedure was used toconjugate ERY1 to GST. Maleimide-activated allophycocyanin (InnovaBiosciences) was dissolved in PBS, and conjugated with ERY1 or MIS asdescribed above.

Microscopy of Binding to Erythrocytes

5×10⁵ freshly isolated mouse erythrocytes were exposed to 100 nM ofERY1-OVA or OVA in PBS containing 10 mg/mL BSA for 1 h at 37 C.Following centrifugation and washing, cells were labeled with 1:200diluted goat anti-mouse glycophorin-A (Santa Cruz) and rabbit anti-OVA(AbD SEROTEC) for 20 min on ice. Following centrifugation and washing,cells were labeled with 1:200 ALEXAFLUOR488 anti-goat IgG (Invitrogen)and AlexaFluor546 anti-rabbit IgG (Invitrogen) for 20 min on ice.Following a final spin/wash cycle, cells were hard set mounted andimaged on a Zeiss LSM700 inverted confocal microscope with a 63× oilimmersion objective. Image analysis was conducted in IMAGEJ (NIH), withidentical processing to both images.

In Vivo Binding and Biodistribution

150 μg of ERY1-OVA or OVA in 0.9% saline (B. Braun) in a volume of 100μL was injected intravenously into the tail of 8-12 week old femaleC57BL/6 mice while under anesthesia with isoflurane. Care was taken toensure mice were kept at 37 C with a heating pad during experimentation.At predetermined time points, 5 μL of blood was taken from a smallincision on the tail, diluted 100-fold into 10 mM EDTA in PBS, washedthree times with PBS with 10 mg/mL BSA, and analyzed for OVA content byflow cytometry and ELISA. OVA was quantified by sandwich ELISA, using amouse monoclonal anti-OVA antibody (Sigma) for capture, a polyclonalrabbit anti-OVA antibody (AbD SEROTEC) for detection, a goatanti-rabbit-IgG-HRP antibody (BioRad) for final detection, followed byTMB substrate (GE Life Sciences). Hematological characterization wasperformed on an ADVIVA 2120 Hematology System (Siemens).Erythrocyte-bound ERY1-GST was detected by incubating labeled cells withgoat anti-GST (GE Healthcare Life Sciences), followed by incubation withAlexaFluor488 donkey anti-goat (Invitrogen), and analyzed by flowcytometry. For biodistribution studies, 20 μg of ERY1-APC or MIS-APC wasinjected intravenously into the tail vein of 8-12 week old femaleC57BL/6 mice as described above. Mice were sacrificed at predeterminedtime points, and the spleen, blood, and liver were removed. Each organwas digested with collagenase D (Roche) and homogenized to obtain asingle-cell suspension for flow cytometry staining.

T Cell Adoptive Transfer

CD8⁺ T cells from OT-I (CD45.2⁺) mouse spleens were isolated using a CD8magnetic bead negative selection kit (Miltenyi Biotec) as per themanufacturer's instructions. Freshly isolated CD8⁺ OT-I cells wereresuspended in PBS and labeled with 1 carboxyfluorescein succinimidylester (CF SE, Invitrogen) for 6 min at room temperature, and thereaction was quenched for 1 min with an equal volume of IMDM with 10%FBS (Gibco). Cells were washed, counted, and resuspended in pure IMDMprior to injection. 3×10⁶ CF SE-labeled CD8⁺ OT-I cells were injectedintravenously into the tail vein of recipient CD45.1⁺ mice. Forshort-term proliferation studies, 10 μg of ERY1-OVA or OVA in 100 μLvolume was injected 24 h following adoptive transfer. Splenocytes wereharvested 5 d following antigen administration and stained for analysisby flow cytometry.

OT-I Tolerance and Challenge Model

3×10⁵ CFSE-labeled OT-I CD8⁺ T cells were injected into CD45.1⁺recipient mice as described above. 1 and 6 d following adoptivetransfer, mice were intravenously administered 10 μg of ERY1-OVA or OVAin 100 μL saline into the tail vein. 15 d following adoptive transfer,mice were challenged with 5 μg OVA and 25 ng ultra-pure Escherichia coliLPS (InvivoGen) in 25 μL intradermally into each rear leg pad (Hockmethod, total dose of 10 μg OVA and 50 ng LPS). Mice were sacrificed 4 dfollowing challenge, and spleen and draining lymph node cells wereisolated for restimulation. For flow cytometry analysis of intracellularcytokines, cells were restimulated in the presence of 1 mg/mL OVA or 1μg/mL SIINFEKL (SEQ ID NO:3) peptide (Genscript) for 3 h. Brefeldin-A(Sigma, 5 μg/mL) was added and restimulation resumed for an additional 3h prior to staining and flow cytometry analysis. For ELISA measurementsof secreted factors, cells were restimulated in the presence of 100μg/mL OVA or 1 μg/mL SIINFEKL (SEQ ID NO:3) peptide for 4 d. Cells werespun and the media collected for ELISA analysis using IFNγ and IL-10Ready-Set-Go kits (eBiosciences) as per the manufacturer's instructions.OVA-specific serum IgG was detected by incubating mouse serum at varyingdilutions on OVA-coated plates, followed by a final incubation with goatanti-mouse IgG-HRP (Southern Biotech).

OT-I E.G7-OVA Tolerance Model

1×106 CFSE-labeled OT-I CD8+ T cells were injected into 8-12 wk oldfemale C57BL/6 mice as described above. 1 and 6 d following adoptivetransfer, mice were intravenously administered 10 μg of ERY1-OVA or 10μg OVA in 100 μL saline into the tail vein. Blood was drawn 5 dfollowing adoptive transfer for characterization of OT-I CD8+ T cellproliferation by flow cytometry. OVA-expressing EL-4 thymoma cells(E.G7-OVA, ATCC CRL-2113) were cultured as per ATCC guidelines. Inbrief, cells were cultured in RPMI 1640 medium supplemented with 10%fetal bovine serum, 10 mM HEPES, 1 mM sodium pyruvate, 0.05 mMβ-mercaptoethanol, 1% puromycin/streptomycin (Invitrogen Gibco), and 0.4mg/mL G418 (PAA Laboratories). Just prior to injection, cells wereexpanded in media without G418 and resuspended upon harvest in HBSS(Gibco). 9 d following adoptive transfer, mice were anesthetized withisoflurane, the back area was shaved, and 1×106 E.G7-OVA cells wereinjected intradermally between the shoulder blades. 4 d followingE.G7-OVA graft, tumor dimensions were measured every 24 h with a digitalcaliper, and tumor volume was calculated as an ellipsoid (V=(□/6)1·w·h), where V is volume, 1 is length, w is width, and h is the heightof the tumor). 15 d following adoptive transfer, mice were challengedwith 5 μg OVA and 25 ng ultra-pure Escherichia coli LPS (InvivoGen) in25 μL intradermally into each front leg pad (total dose of 10 μg OVA and50 ng LPS).

Antibodies and Flow Cytometry

The following anti-mouse antibodies were used for flow cytometry: CD1dPacific Blue, CD3ε PerCP-Cy5.5, CD8α PE-Cy7, CD11b PE-Cy7, CD11c PacificBlue, biotinylated CD45, CD45.2 Pacific Blue, CD45 Pacific Blue,IFNγ-APC, CD8γ APC-eF780, CD44 PE-Cy5.5, CD62L PE, CD205 PE-Cy7, F4/80PE, I-A/I-E MHCII FITC (all from eBioscience), in addition to fixablelive/dead dye (Invitrogen), annexin-V-Cy5 labeling kit (BioVision),streptavidin Pacific Orange (Invitrogen), and anti-OVA-FITC (Abcam).Samples were analyzed on a CyAn ADP flow cytometer (Beckman Coulter).Cells were washed first with PBS, stained for 20 min on ice withlive/dead dye, blocked for 20 min on ice with 24G2 hybridoma medium,surface stained for 20 min on ice, fixed in 2% paraformaldehyde for 20min ice, intracellularly stained in the presence of 0.5% saponin for 45min on ice, followed by a final wash prior to analysis. For apoptosisstaining, annexin-V-Cy5 was added 5 min prior to analysis. For CD45staining, cells were stained with streptavidin Pacific Orange for 20 minon ice, washed, and analyzed.

Implementation with Particles

The ERY1 peptide has also been implemented for tolerogenesis in the formof nanoparticles, to which the ERY1 peptide and the tolerogenic antigenare both conjugated.

To form conjugates of ERY1 with a polymer nanoparticle, which is alsoconjugated to the peptide or protein antigen, stoichiometric amounts ofeach component may be added consecutively to control conjugationconversions. To form a nanoparticle conjugated with both OVA and ERY1 ormismatch peptide, the peptides were first dissolved in aqueous 3Mguanidine HCl, and 0.5 equivalents were added to nanoparticlescontaining a thiol-reactive pyridyldisulfide group. Absorbancemeasurements were taken at 343 nm to monitor the reaction conversion, asthe reaction creates a non-reactive pyridine-2-thione species with ahigh absorbance at this wavelength. Following 2 h at room temperature,the absorbance at 343 nm had stabilized and OVA was dissolved in aqueous3M guanidine HCl, and added to the nanoparticle solution at a 2-foldmolar excess. Following 2 h at room temperature, the absorbance at 343nm had once again stabilized to a higher value, and the concentrationsof both the peptide and OVA in the solution were calculated. Thebifunctionalized nanoparticles were purified from non-reacted componentsby gel filtration on a Sepharose CL6B packed column. Each 0.5 mLfraction was analyzed for the presence of protein and/or peptide byfluorescamine, and nanoparticle size was assessed by dynamic lightscattering (DLS).

Should the antigen not contain any free thiol groups to perform such areaction, they may be introduced by recombinant DNA technology to createa mutant that could then be expressed and purified recombinantly.Alternatively, amine-carboxylic acid crosslinking could be performedbetween the nanoparticle and antigen using1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC).

To form conjugates of ERY1 with a polymer micelle, which is alsoconjugated to the peptide or protein antigen, similar reactions would beused as described with polymeric nanoparticles. The micelle would beformed to contain functional groups desired for the appropriateconjugation scheme. Given that our nanoparticles and micelles may besynthesized to contain many different chemical group functionalizations,there exist numerous possibilities of conjugation schemes to employ increating the nanoparticle/micelle-antigen-ERY1 complex.

Example 15 Development of Antibodies and Antibody-Fragments with thatBind Mouse and/or Human Erythrocytes

As another method to non-covalently bind erythrocytes, anerythrocyte-binding antibody may also be used to induce antigen-specificimmunological tolerance. Antibodies displaying high affinity towardserythrocyte surface proteins may be isolated by screening antibodylibraries using state-of-the art display platforms, including but notlimited to bacteriophage display, yeast and E. coli surface display.Upon discovery of the novel erythrocyte-binding antibody, similarbiochemical characterization of binding may be assessed as was performedwith the ERY1 peptide. In order to create higher-affinity mutants withimproved binding characteristics, affinity maturation is conducted onthe antibody fragments discovered to bind erythrocytes from the initiallibrary screening. Using standard recombinant DNA techniques, such aserror-prone PCR and site-directed mutagenesis, a new library is createdfrom the parent binding sequence. The affinity maturation library isthen displayed using state-of-the-art display platforms, as describedabove, for other antibody fragments with enhanced affinity forerythrocytes as compared with the parent binding sequence.

Affinity maturation is also performed on existing antibodies that bindeither mouse erythrocytes or human erythrocytes. The rat monoclonalTER-119 clone antibody (Kina et al, Br J Haematol, 2000) binds mouseerythrocytes at a site yet to be fully determined, yet its specificityhas led to its common use in removal of erythrocytes from heterogeneouscellular populations. Affinity maturation is performed on the TER-119antibody, either as a full-length antibody or as an antibody fragmentsuch as an scFv, to discover new antibodies with increased affinitytowards mouse erythrocytes. The mouse monoclonal 10F7 clone antibody(Langlois et al, J Immunol 1984) binds to human glycophorin-A on thehuman erythrocyte cell surface. Affinity maturation is performed on the10F7 antibody, either as a full-length antibody or as an antibodyfragment such as an scFv, to discover new antibodies with increasedaffinity towards human erythrocytes.

To determine the primary sequence of the TER-119 antibody, we cloned theantibody-specific isolated cDNA from the TER-119 hybridoma into aplasmid allowing for facile sequencing of the gene fragments. A specificset of primers were used for the PCR amplification process of theantibody genes that allows for amplification of the multiple variabledomains of the gene segments (Krebber et al., 1997; Reddy et al., 2010).The DNA sequence of the antibody domains allowed us to determine thevariable regions of the heavy and light chains of the TER-119 IgGantibody. To construct an scFv version of the TER-119 IgG, we usedassembly PCR to create a gene comprising of the variable heavy chain ofTER-119, followed by a (Gly-Gly-Gly-Gly-Ser)4 (SEQ ID NO:18) linker,followed by the variable light chain of TER-119.

Standard reverse transcriptase PCR (RT-PCR) was performed on mRNA fromthe TER-119 hybridoma clone using the Superscript III First StrandSynthesis System (Invitrogen) to create complimentary DNA (cDNA) of theclone. PCR was then conducted using the following set of primers tospecifically amplify the DNA sequences of the variable heavy (VH) andvariable light (VL) regions of the antibody:

Primer SEQ ID name Primer sequence (5′ to 3′) NO VL-AGC CGG CCA TGG CGG AYA TCC AGC TGA  SEQ ID FOR1 CTC AGC C NO: 28 VL-AGC CGG CCA TGG CGG AYA TTG TTC TCW  SEQ ID FOR2 CCC AGT C NO: 29 VL-AGC CGG CCA TGG CGG AYA TTG TGM TMA  SEQ ID FOR3 CTC AGT C NO: 30 VL-AGC CGG CCA TGG CGG AYA TTG TGY TRA  SEQ ID FOR4 CAC AGT C NO: 31 VL-AGC CGG CCA TGG CGG AYA TTG TRA TGA  SEQ ID FOR5 CMC AGT C NO: 32 VL-AGC CGG CCA TGG CGG AYA TTM AGA TRA  SEQ ID FOR6 MCC AGT C NO: 33 VL-AGC CGG CCA TGG CGG AYA TTC AGA TGA  SEQ ID FOR7 YDC AGT C NO: 34 VL-AGC CGG CCA TGG CGG AYA TYC AGA TGA  SEQ ID FOR8 CAC AGA C NO: 35 VL-AGC CGG CCA TGG CGG AYA TTG TTC TCA  SEQ ID FOR9 WCC AGT C NO: 36 VL-AGC CGG CCA TGG CGG AYA TTG WGC TSA  SEQ ID FOR10 CCC AAT C NO: 37 VL-AGC CGG CCA TGG CGG AYA TTS TRA TGA  SEQ ID FOR11 CCC ART C NO: 38 VL-AGC CGG CCA TGG CGG AYR TTK TGA TGA  SEQ ID FOR12 CCC ARA C NO: 39 VL-AGC CGG CCA TGG CGG AYA TTG TGA TGA  SEQ ID FOR13 CBC AGK C NO: 40 VL-AGC CGG CCA TGG CGG AYA TTG TGA TAA  SEQ ID FOR14 CYC AGG A NO: 41 VL-AGC CGG CCA TGG CGG AYA TTG TGA TGA  SEQ ID FOR15 CCC AGW T NO: 42 VL-AGC CGG CCA TGG CGG AYA TTG TGA TGA  SEQ ID FOR16 CAC AAC C NO: 43 VL-AGC CGG CCA TGG CGG AYA TTT TGC TGA  SEQ ID FOR17 CTC AGT C NO: 44 VL-AGC CGG CCA TGG CGG ARG CTG TTG TGA  SEQ ID FOR18 CTC AGG AAT C NO: 45VL- GAT GGT GCG GCC GCA GTA CGT TTG ATT  SEQ ID REV1 TCC AGC TTG GNO: 46 VL- GAT GGT GCG GCC GCA GTA CGT TTT ATT  SEQ ID REV2ATCC GC TTG G NO: 47 VL- GAT GGT GCG GCC GCA GTA CGT TTT ATT  SEQ IDREV3 TCC AAC TTT G NO: 48 VL- GAT GGT GCG GCC GCA GTA CGT TTC AGC SEQ ID REV4 TCC AGC TTG G NO: 49 VL-GAT GGT GCG GCC GCA GTA CCT AGG ACA  SEQ ID REV5 GTC AGT TTG G NO: 50VL- GAT GGT GCG GCC GCA GTA CCT AGG ACA  SEQ ID REV6 GTG ACC TTG GNO: 51 VH- GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR1GGC GGA KGT RMA GCT TCA GGA GTC NO: 52 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR2GGC GGA GGT BCA GCT BCA GCA GTC NO: 53 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR3GGC GCA GGT GCA GCT GAA GSA STC NO: 54 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR4GGC GGA GGT CCA RCT GCA ACA RTC NO: 55 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR5GGC GCA GGT YCA GCT BCA GCA RTC NO: 56 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR6GGC GCA GGT YCA RCT GCA GCA GTC NO: 58 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR7GGC GCA GGT CCA CGT GAA GCA GTC NO: 59 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR8GGC GGA GGT GAA SST GGT GGA ATC NO: 60 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR9GGC GGA VGT GAW GYT GGT GGA GTC NO: 61 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR10GGC GGA GGT GCA GSK GGT GGA GTC NO: 62 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR11GGC GGA KGT GCA MCT GGT GGA GTC NO: 63 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR12GGC GGA GGT GAA GCT GAT GGA RTC NO: 64 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR13GGC GGA GGT GCA RCT TGT TGA GTC NO: 65 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR14GGC GGA RGT RAA GCT TCT CGA GTC NO: 66 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR15GGC GGA AGT GAA RST TGA GGA GTC NO: 67 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR16GGC GCA GGT TAC TCT RAA AGW GTS TG NO: 68 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR17GGC GCA GGT CCA ACT VCA GCA RCC NO: 69 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR18GGC GGA TGT GAA CTT GGA AGT GTC NO: 70 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT  SEQ ID FOR19GGC GGA GGT GAA GGT CAT CGA GTC NO: 71 VH-CCC TTG AAG CTT GCT GAG GAA ACG GTG  SEQ ID REV1 ACC GTG GT NO: 72 VH-CCC TTG AAG CTT GCT GAG GAG ACT GTG  SEQ ID REV2 AGA GTG GT NO: 73 VH-CCC TTG AAG CTT GCT GCA GAG ACA GTG  SEQ ID REV3 ACC AGA GT NO: 74 VH-CCC TTG AAG CTT GCT GAG GAG ACG GTG  SEQ ID REV4 ACT GAG GT NO: 75

The amplified VH and VL genes were then digested with restrictionendonucleases (NcoI and NotI for VL, NdeI and HindIII for VH), the genefragments were purified following agarose electrophoresis using astandard kit (Zymo Research, Orange, Calif., USA), and ligated into acloning plasmid pMAZ360. The plasmid containing either the VH or VL genewas sequenced, and a new gene was constructed using assembly PCR tocreate the TER-119 scFv sequence:

5′-GAGGTGAAGCTGCAGGAGTCTGGAGGAGGCTTGGTGCAACCTGGGGGGTCTCTGAAACTCTCCTGTGTAGCCTCAGGATTCACTTTCAGGGACCACTGGATGAATTGGGTCCGGCAGGCTCCCGGAAAGACCATGGAGTGGATTGGAGATATTAGACCTGATGGCAGTGACACAAACTATGCACCATCTGTGAGGAATAGATTCACAATCTCCAGAGACAATGCCAGGAGCATCCTGTACCTGCAGATGAGCAATATGAGATCTGATTACACAGCCACTTATTACTGTGTTAGAGACTCACCTACCCGGGCTGGGCTTATGGATGCCTGGGGTCAAGGAACCTCAGTCACTGTCTCCTCAGCCGGTGGTGGTGGTTCTGGTGGTGGTGGTTCTGGCGGCGGCGGCTCCGGTGGTGGTGGATCCGACATTCAGATGACGCAGTCTCCTTCAGTCCTGTCTGCATCTGTGGGAGACAGAGTCACTCTCAACTGCAAAGCAAGTCAGAATATTAACAAGTACTTAAACTGGTATCAGCAAAAGCTTGGAGAAGCTCCCAAAGTCCTGATATATAATACAAACAATTTGCAAACGGGCATCCCATCAAGGTTCAGTGGCAGTGGATCTGGTACAGATTTCACACTCACCATCAGTAGCCTGCAGCCTGAAGATTTTGCCACATATTTCTGCTTTCAGCATTATACTTGGCCCACGTTTGGAGGTGGGACCAAGCTGGAAATCAAACGTACT-3′ (SEQ ID NO:76),which encodes for the VH region of the TER-119 clone at the N terminusof the translated protein, followed by a (Gly-Gly-Gly-Gly-Ser)₄ (SEQ IDNO:18) linker domain, followed by the VL region of the TER-119 clone atthe C terminus of the translated protein. The TER-119 scFv gene wasconstructed by amplifying the TER-119 cDNA with primers SK07 and SK08,specific for the VH region, and SK09 and SK10, specific for the VLregion:

Primer SEQ ID name Primer sequence (5′ to 3′) NO SK07ACT CGC GGC CCA GCC GGC CAT GGC GGA  SEQ ID GGT GAA GCT GCA GGA GTCNO: 77 SK08 GGA GCC GCC GCC GCC AGA ACC ACC ACC  SEQ IDACC AGA ACC ACC ACC ACC GGC TGA GGA  NO: 78 GAC AGT GAC TG SK09GGC GGC GGC GGC TCC GGT GGT GGT GGA  SEQ IDTCC GAC ATT CAG ATG ACG CAG TC NO: 79 SK10GAC TAC TAG GCC CCC GAG GCC AGT ACG  SEQ ID TTT GAT TTC CAG CT NO: 80

Each final completed scFv gene product was digested with SfiI and XhoI(NEB, Ipswich, Mass., USA), and ligated into the same sites on thepSecTagA mammalian expression plasmid (Invitrogen, Carlsbad, Calif.,USA).

To affinity mature the 10F7 scFv that binds to human glycophorin-A, thegene was commercially synthesized and obtained from DNA2.0 (Menlo Park,Calif., USA) as the following sequence:

(SEQ ID NO: 81) 5′-GTTATTACTCGCGGCCCAGCCGGCCATGGCGGCGCAGGTGAAACTGCAGCAGAGCGGCGCGGAACTGGTGAAACCGGGCGCGAGCGTGAAACTGAGCTGCAAAGCGAGCGGCTATACCTTTAACAGCTATTTTATGCATTGGATGAAACAGCGCCCGGTGCAGGGCCTGGAATGGATTGGCATGATTCGCCCGAACGGCGGCACCACCGATTATAACGAAAAATTTAAAAACAAAGCGACCCTGACCGTGGATAAAAGCAGCAACACCGCGTATATGCAGCTGAACAGCCTGACCAGCGGCGATAGCGCGGTGTATTATTGCGCGCGCTGGGAAGGCAGCTATTATGCGCTGGATTATTGGGGCCAGGGCACCACCGTGACCGTGAGCAGCGGCGGCGGCGGCAGCGGCGGCGGCGGCAGCGGCGGCGGCGGCAGCGATATTGAACTGACCCAGAGCCCGGCGATTATGAGCGCGACCCTGGGCGAAAAAGTGACCATGACCTGCCGCGCGAGCAGCAACGTGAAATATATGTATTGGTATCAGCAGAAAAGCGGCGCGAGCCCGAAACTGTGGATTTATTATACCAGCAACCTGGCGAGCGGCGTGCCGGGCCGCTTTAGCGGCAGCGGCAGCGGCACCAGCTATAGCCTGACCATTAGCAGCGTGGAAGCGGAAGATGCGGCGACCTATTATTGCCAGCAGTTTACCAGCAGCCCGTATACCTTTGGCGGCGGCACCAAACTGGAAATTAAACGCGCGGCGGCGGCCTCGGGGGCCGAGGGCGGCGGTTC T-3′.

Similar affinity maturation using recombinant DNA techniques describedabove for TER-119 is performed on the 10F7 gene to obtain a library ofmutants to enable screening for enhanced binding towards humanerythrocytes.

Example 16 Inducing Antigen-Specific Immunological Tolerance ThroughNon-Covalent Erythrocyte-Binding with Antibody-Conjugated Antigen

The antibody may be conjugated with the antigen using standardcrosslinking reactions as mentioned in Example 14 and elsewhere herein.The purified antibody-antigen conjugate will exhibit induction oftolerance towards the antigen in standard mouse models of type 1diabetes, multiple sclerosis, islet transplantation, and OVA modelantigen.

In order to demonstrate the induction of tolerance towards OVA, theOVA-antibody conjugate or OVA-nanoparticle-antibody conjugate may beadministered either intravenously or extravascularly to mice. At apredetermined number of days following administration, mice are to besacrificed and lymph nodes, spleen, and blood harvested for analysis.Splenocytes and lymph node derived cells are plated and re-stimulatedfor 3 days ex vivo with OVA and/or SIINFEKL peptide, and theirdown-regulation of IFNγ, IL-17a, IL-2, and IL-4 expression, andup-regulation of TGF-β1, which are established evidence of tolerance,are measured by ELISA. Intracellular staining of IFNγ, IL-17a, IL-2, andIL-4 are performed using flow cytometry on splenocytes and lymph nodederived cells following 6 h of ex vivo re-stimulation with OVA and/orSIINFEKL peptide. Furthermore, flow cytometry is used to characterizethe expression profiles of CD4, CD8, and regulatory T-cells from lymphnode, spleen, and blood derived cells. Additionally, blood samples aretaken from mice at varying time points to measure humoral antibodyresponses towards the OVA antigen. A variant experiment of the ex vivore-stimulation is performed to determine if systemic tolerance has beenestablished. Mice are administered with OVA-antibody conjugate orOVA-antibody-nanoparticle conjugate as described above, OVA isre-administered 9 days later with an adjuvant (lipopolysaccharide,complete Freud's adjuvant, alum, or other), and splenocyteresponsiveness to the OVA antigen is assessed by ELISA and/or flowcytometry as described above. The OVA-antibody conjugate and/orOVA-antibody-nanoparticle formulation will render splenocytesnon-responsive to the second challenge with OVA and adjuvant, which isone method to demonstrate effective establishment of systemic tolerance.Following initial administration with OVA-antibody conjugate and/orOVA-antibody-nanoparticle formulations, similar in vivo challengeexperiments may be conducted with transgenic cell lines as a furtherdemonstration of tolerance, such as adoptive transfer with OT-I T cells,similar to studies described in detail in Example 14. To demonstrateimmune tolerance in mouse models of autoimmunity or deimmunization oftherapeutic molecules, analogous antibody conjugates may be made to therelevant antigens as was described herein with OVA.

Example 17 Inducing Antigen-Specific Immunological Tolerance ThroughNon-Covalent Erythrocyte-Binding with Single Chain Antibody-FusedAntigen

Single chain antibody fragments (scFv's) may be used as non-covalentbinders to erythrocytes. ScFv's displaying high affinity towardserythrocyte surface proteins may be isolated by screening scFv librariesusing state-of-the-art display platforms, as discussed in Example 13.Upon discovery of the novel erythrocyte-binding antibody fragment,similar biochemical characterization of binding are to be assessed aswas performed with the ERY1 peptide. As the scFv has one polypeptidechain, it will be fused to the antigen in a site-specific recombinantmanner using standard recombinant DNA techniques. Depending on thenature of the antigen fusion partner, the scFv is fused to the N- orC-terminus of the antigen to create the bifunctional protein species. Inthe case where the major histocompatibility complex (MHC) peptiderecognition sequence is known for the antigen, the peptide is alsoinserted into the linker domain of the scFv, thus creating a newbifunctional antibody/antigen construct containing the native termini ofthe scFv.

In order to demonstrate the induction of tolerance towards OVA, anOVA-scFv or OVA-nanoparticle-scFv conjugate may be administered eitherintravenously or extravascularly to mice. At a predetermined number ofdays following administration, mice are to be sacrificed and lymphnodes, spleen, and blood are to be harvested for analysis. Splenocytesand lymph node derived cells are to be plated and re-stimulated for 3days ex vivo with OVA and/or SIINFEKL peptide (SEQ ID NO:3), and theirdown-regulation of IFNγ, IL-17a, IL-2, and IL-4 expression, andup-regulation of TGF-β1, which are established evidence of tolerance,are to be measured, e.g., by ELISA. Intracellular staining of IFNγ,IL-17a, IL-2, and IL-4 is performed using flow cytometry on splenocytesand lymph node derived cells following 6 h of ex vivo re-stimulationwith OVA and/or SIINFEKL peptide(SEQ ID NO:3). Furthermore, flowcytometry may be used to characterize the expression profiles of CD4,CD8, and regulatory T-cells from lymph node, spleen, and blood derivedcells. Additionally, blood samples are taken from mice at varying timepoints to measure humoral antibody responses towards the OVA antigen. Avariant experiment of the ex vivo re-stimulation is performed todetermine if systemic tolerance has been established. Mice areadministered with OVA-scFv or OVA-nanoparticle-scFv conjugate asdescribed above, OVA is re-administered 9 days later with an adjuvant(lipopolysaccharide, complete Freud's adjuvant, alum, or other), andsplenocyte responsiveness to the OVA antigen is assessed by ELISA and/orflow cytometry as described above. The OVA-scFv and/orOVA-scFv-nanoparticle formulation will render splenocytes non-responsiveto the second challenge with OVA and adjuvant, thereby illustratingeffective establishment of systemic tolerance. Following initialadministration with OVA-scFv and/or OVA-scFv-nanoparticle formulations,similar in vivo challenge experiments may be conducted with transgeniccell lines to demonstrate tolerance, such as adoptive transfer with OT-IT cells, similar to studies described in detail in Example 14. Todemonstrate immune tolerance in mouse models of autoimmunity ordeimmunization of therapeutic molecules, analogous scFv fusions may bemade to the relevant antigens as was described here with OVA.

Standard recombinant DNA techniques were used to create an antibodyconstruct that both binds mouse erythrocytes and displays theimmunodominant epitope of OVA (SGLEQLESIINFEKL) (SEQ ID NO:82). Usingoverlap extension PCR, we first created a DNA fragment that encoded forthe terminal 3′ domain, including the SGLEQLESIINFEKL(SEQ ID NO:82)peptide with an overlapping 5′ domain that is complimentary to the 3′terminus of the TER119 sequence. This DNA fragment was used as a reverseprimer, along with a complimentary forward 5′ primer, in a standard PCRto create the entire DNA fragment encoding for TER119-SGLEQLESIINFEKL(SEQ ID NO:82):

(SEQ ID NO: 83) 5′- GAGGTGAAGCTGCAGGAGTCTGGAGGAGGCTTGGTGCAACCTGGGGGGTCTCTGAAACTCTCCTGTGTAGCCTCAGGATTCACTTTCAGGGACCACTGGATGAATTGGGTCCGGCAGGCTCCCGGAAAGACCATGGAGTGGATTGGAGATATTAGACCTGATGGCAGTGACACAAACTATGCACCATCTGTGAGGAATAGATTCACAATCTCCAGAGACAATGCCAGGAGCATCCTGTACCTGCAGATGAGCAATATGAGATCTGATTACACAGCCACTTATTACTGTGTTAGAGACTCACCTACCCGGGCTGGGCTTATGGATGCCTGGGGTCAAGGAACCTCAGTCACTGTCTCCTCAGCCGGTGGTGGTGGTTCTGGTGGTGGTGGTTCTGGCGGCGGCGGCTCCGGTGGTGGTGGATCCGACATTCAGATGACGCAGTCTCCTTCAGTCCTGTCTGCATCTGTGGGAGACAGAGTCACTCTCAACTGCAAAGCAAGTCAGAATATTAACAAGTACTTAAACTGGTATCAGCAAAAGCTTGGAGAAGCTCCCAAAGTCCTGATATATAATACAAACAATTTGCAAACGGGCATCCCATCAAGGTTCAGTGGCAGTGGATCTGGTACAGATTTCACACTCACCATCAGTAGCCTGCAGCCTGAAGATTTTGCCACATATTTCTGCTTTCAGCATTATACTTGGCCCACGTTTGGAGGTGGGACCAAGCTGGAAATCAAACGTACTCATCATCACCATCATCACGGTGGCGGTTCTGGCCTGGAGCAGCTGGAGTCTATTATTAATTTCGAAAAACTG-3′.The underlined sequence denotes the gene segment encoding forSGLEQLESIINFEKL. The DNA fragment was inserted into a mammalian andprokaryotic expression vector for recombinant expression.

Standard recombinant DNA techniques were used to create an antibodyconstruct that both binds mouse erythrocytes and displays thechromogranin-A mimetope 1040-p31 (YVRPLWVRME) (SEQ ID NO:84). Usingoverlap extension PCR, a DNA fragment was created that encoded for theterminal 3′ domain, including the YVRPLWVRME (SEQ ID NO:84) peptide withan overlapping 5′ domain that is complimentary to the 3′ terminus of theTER119 sequence. This DNA fragment was used as a primer, along with acomplimentary forward 5′ primer, in a standard PCR to create the entireDNA fragment encoding for TER119-YVRPLWVRME:

(SEQ ID NO: 85) 5′- GAGGTGAAGCTGCAGGAGTCAGGAGGAGGCTTGGTGCAACCTGGGGGGTCTCTGAAACTCTCCTGTGTAGCCTCAGGATTCACTTTCAGGGACCACTGGATGAATTGGGTCCGGCAGGCTCCCGGAAAGACCATGGAGTGGATTGGGGATATTAGACCTGATGGCAGTGACACAAACTATGCACCATCTGTGAGGAATAGATTCACAATCTCCAGAGACAATACCAGGAGCATCCTGTACCTGCAGATGGGCAATATGAGATCTGATTACACAGCCACTTATTACTGTGTTAGAGACTCACCTACCCGGGCTGGGCTTATGGATGCCTGGGGTCAAGGAACCTCAGTCACTGTCTCCTCAGCCGGTGGTGGTGGTTCTGGTGGTGGTGGTTCTGGCGGCGGCGGCTCCGGTGGTGGTGGATCCGACATTCAGATGACGCAGTCTCCTTCAGTCCTGTCTGCATCTGTGGGAGACAGAGTCACTCTCAACTGCAAAGCAAGTCAGAATATTAACAAGTACTTAAACCGGTATCAGCAAAAGCTTGGAGAAGCTCCCAAAGTCCTGGTATATAATACAAACAATTTGCAAACGGGCATCCCATCAAGGTTCAGTGGCAGTGGATCTGGCACAGATTTCACACTCACCATCAGTAGCCTGCAGCCTGAAGATTTTGCCACATATTTCTGCTTTCAGCATTATACTTGGCCCACGTTTGGAGGTGTGACCAAGCTGGAAATCAAACGTACTCATCATCACCATCATCACGGTGGCGGTTATGTCAGACCTCTGTGGGTCAGAAT GGAA-3′.The underlined sequence denotes the gene segment encoding for thechromogranin-A (1040-p31) mimetope (YVRPLWVRME) (SEQ ID NO:84). The DNAfragment was inserted into a mammalian and prokaryotic expression vectorfor recombinant expression.

Standard recombinant DNA techniques were used to create an antibodyconstruct that both binds mouse erythrocytes and displays mouseproinsulin, a major diabetes autoantigen in the NOD mouse. Using overlapextension PCR, we first created a DNA fragment that encoded for theterminal 3′ domain, including the entire proinsulin protein, with anoverlapping 5′ domain that is complimentary to the 3′ terminus of theTER119 sequence. This DNA fragment was used as a primer, along with acomplimentary forward 5′ primer, in a standard PCR to create the entireDNA fragment encoding for TER119-proinsulin:

(SEQ ID NO: 86) 5′- GAGGTGAAGCTGCAGGAGTCAGGAGGAGGCTTGGTGCAACCTGGGGGGTCTCTGAAACTCTCCTGTGTAGCCTCAGGATTCACTTTCAGGGACCACTGGATGAATTGGGTCCGGCAGGCTCCCGGAAAGACCATGGAGTGGATTGGAGATATTAGACCTGATGGCAGTGACACAAACTATGCACCATCTGTGAGGAATAGATTCACAATCTCCAGAGACAATGCCAGGAGCATCCTGTACCTGCAGATGAGCAATATGAGATCTGATTACACAGCCACTTATTACTGTGTTAGAGACTCACCTACCCGGGCTGGGCTTATGGATGCCTGGGGTCAAGGAACCTCAGTCACTGTCTCCTCAGCCGGTGGTGGTGGTTCTGGTGGTGGTGGTTCTGGCGGCGGCGGCTCCGGTGGTGGTGGATCCGACATTCAGATGACGCAGTCTCCTTCAGTCCTGTCTGCATCTGTGGGAGACAGAGTCACTCTCAACTGCAAAGCAAGTCAGAATATTAACAAGTACTTAAACTGGTATCAGCAAAAGCTTGGAGAAGCTCCCAAAGTCCTGATATATAATACAAACAATTTGCAAACGGGCATCCCATCAAGGTTCAGTGGCAGTGGATCTGGTACAGATTTCACACTCACCATCAGTAGCCTGCAGCCTGAAGATTTTGCCACATATTTCTGCTCTCAGCATTATACTTGGCCCACGTTTGATGGTGGGACCAAGCTGGAAATCAAACGTACTCATCATCACCATCATCACGGTGGCGGTTTTGTGAAACAGCATCTGTGCGGTCCGCATCTGGTGGAAGCGCTGTATCTGGTGTGCGGCGAACGTGGCTTTTTTTATACCCCGAAAAGCCGTCGTGAAGTGGAAGATCCGCAGGTGGAACAGCTGGAACTGGGCGGCAGCCCGGGTGATCTGCAGACCCTGGCCCTGGAAGTGGCGCGTCAGAAACGTGGCATTGTGGATCAGTGCTGCACCAGCATTTGCAGCCTGTATCAGCTGGAAAACTATTACAAC-3′.The underlined sequence denotes the proinsulin gene segment of theconstruct. The DNA fragment was inserted into a mammalian andprokaryotic expression vector for recombinant expression.

Example 18 Synthesis of Branched Polymers Comprising Erythrocyte BindingLigands and Other Functions

For the synthesis of 8-arm PEG-thioacetate, 8-arm PEG-OH (Nektar) wasdissolved in toluene and reacted for 18 h with 10 equivalents oftriethylamine (Sigma Aldrich, CAS #121-44-8) and 10 equivalents ofmethanesulfonyl chloride (Sigma Aldrich, CAS #124-63-0) at roomtemperature under argon. The residue was filtered and the filtrateconcentrated under reduced pressure, dissolved in dimethylformamide(DMF), and 10 equivalents of potassium thioacetate (Sigma Aldrich, CAS#10387-40-3) was added. After 18 h at room temperature, the residue wasfiltered, the filtrate was concentrated under reduced pressure andprecipitated in diethyl ether. The precipitate was filtered and driedunder reduced pressure to obtain the final product.

For the synthesis of 8-arm PEG-pyridyldisulfide, 8-arm PEG-thioacetatewas dissolved in dimethylformamide (DMF) and deprotected with 1.05equivalents of sodium methoxide (Sigma Aldrich, CAS #124-41-4) for 1 hat room temperature under argon in a Schlenk tube. To reduce thedeprotected thiols to thiolates, 2 equivalents ofTris(2-carboxyethyl)phosphine hydrochloride (TCEP, Thermo Scientific,CAS #51805-45-9) and 2 equivalents of distilled water were added to thesolution. After 2 h at room temperature, 12 equivalents of2,2′-dithiodipyridine (Aldrithiol-2, Sigma Aldrich, CAS #2127-03-9) wasadded and the solution was stirred at room temperature for 24 h. Thereaction mixture was then dialyzed against 5 L of distilled water inMWCO 3,500 Da dialysis tubing for 48 h, during which the distilled waterwas changed 4 times. Pyridyldisulfide loading onto the 8-arm PEG wasquantified by reduction in 25 mM TCEP in 100 mM HEPES, pH 8.0, andUV-vis spectra were measured at 343 nm to monitor the presence of thepyridine-2-thione leaving group.

For the synthesis of 8-arm PEG-pyridyldisulfide-ALEXAFLUOR647, 8-armPEG-thioacetate was dissolved in DMF and deprotected with 1.05equivalents of sodium methoxide (Sigma Aldrich, CAS #124-41-4) for 1 hat room temperature under argon in a Schlenk tube. To reduce thedeprotected thiols to thiolates, 2 equivalents ofTris(2-carboxyethyl)phosphine hydrochloride (TCEP, Thermo Scientific,CAS #51805-45-9) and an equal volume of 100 mM HEPES pH 8.0 were addedto the solution. After 2 h at room temperature, 0.125 equivalents(equivalent to 1 arm out of 8) of AlexaFluor647-C2-maleimide(Invitrogen) was added to the solution. After 2 h at room temperature,12 equivalents of 2,2′-dithiodipyridine (Aldrithiol-2, Sigma Aldrich,CAS #2127-03-9) was added and the solution was stirred at roomtemperature for 24 h. The reaction mixture was then dialyzed against 5 Lof distilled water in MWCO 3,500 Da dialysis tubing for 48 h, duringwhich the distilled water was changed 4 times. Pyridyldisulfide loadingonto the 8-arm PEG was quantified by reduction in 25 mM TCEP in 100 mMHEPES, pH 8.0, and UV-vis spectra were measured at 343 nm to monitor thepresence of the pyridine-2-thione leaving group.

Thiol-containing peptides were conjugated to the 8-armPEG-pyridyldisulfide by adding stoichiometric quantities of the peptide,dissolved in aqueous 3 M guanidine-HCl (Sigma Aldrich, CAS #50-01-10),to the aqueous solution of 8-arm PEG-pyridyldisulfide at roomtemperature. Reaction conversion was monitored by measuring UV-visspectra at 343 nm to quantify the presence of the pyridine-2-thioneleaving group. If more than one molecule was to be conjugated to the8-arm PEG-pyridyldisulfide, the reaction procedure was repeated with thenew molecule in the same pot. Once conjugation was completed, thereaction mixture was desalted on a ZEBASPIN desalting column (ThermoScientific), and the purified product was stored under the appropriatesterile conditions.

The induction of tolerance towards OVA could be demonstrated for the8-arm PEG-ERY1/MIS-SIINFEKL conjugate (SIINFEKL: SEQ ID NO:3) byadministering it either intravenously or extravascularly to mice. Thistest would also indicate induction of tolerance in humans usinghuman-specific ligands. In such a demonstration, a predetermined numberof days following administration, mice would be sacrificed and lymphnodes, spleen, and blood harvested for analysis. Splenocytes and lymphnode derived cells are plated and re-stimulated for 3 days ex vivo withOVA and/or SIINFEKL (SEQ ID NO:3) peptide, and their down-regulation ofIFNγ, IL-17a, IL-2, and IL-4 expression, and up-regulation of TGF-β1,which are established evidence of tolerance, are measured by ELISA.Intracellular staining of IFNγ, IL-17a, IL-2, and IL-4 is performedusing flow cytometry on splenocytes and lymph node derived cellsfollowing 6 h of ex vivo re-stimulation with OVA and/or SIINFEKL (SEQ IDNO:3) peptide. Furthermore, flow cytometry is used to characterize theexpression profiles of CD4, CD8, and regulatory T-cells from lymph node,spleen, and blood derived cells. Additionally, blood samples are takenfrom mice at varying time points to measure humoral antibody responsestowards the OVA antigen. A variant experiment of the ex vivore-stimulation is performed to determine if systemic tolerance has beenestablished. Mice are administered with 8-arm PEG-ERY1/MIS-SIINFEKLconjugate (SIINFEKL: SEQ ID NO:3) as described above, OVA isre-administered 9 days later with an adjuvant (lipopolysaccharide,complete Freud's adjuvant, alum, or other), and splenocyteresponsiveness to the OVA antigen is assessed by ELISA and/or flowcytometry as described above. The 8-arm PEG-ERY1-SIINFEKL conjugate(SIINFEKL: SEQ ID NO:3) formulation will render splenocytesnon-responsive to the second challenge with OVA and adjuvant, which is amethod of illustrating effective establishment of systemic tolerance.Following initial administration of the 8-arm PEG-ERY1/MIS-SIINFEKLconjugate formulations (SIINFEKL: SEQ ID NO:3), similar in vivochallenge experiments could be conducted with transgenic cell lines tofurther demonstrate tolerance, such as adoptive transfer with OT-I Tcells, similar to studies described in detail in Example 14. Todemonstrate immune tolerance in mouse models of autoimmunity ordeimmunization of therapeutic molecules, analogous 8-arm PEG constructsmay be made to the relevant antigens as was described here with SIINFEKL(SEQ ID NO:3).

Example 19 Inducing Antigen-Specific Immunological Tolerance ThroughNon-Covalent Erythrocyte-Binding with Aptamer-Conjugated Antigen

Methods may be performed using other non-antibody bioaffinity reagentsto measure their ability to induce immunological tolerance throughnon-covalent erythrocyte binding. Other protein-based affinity moieties,such as designed ankyrin repeat proteins (DARPins) (Steiner, Forrer, etal., 2008), designed armadillo repeat proteins (Parmeggiani, Pellarin,et al., 2008), fibronectin domains (Hackel, Kapila, et al., 2008), andcysteine-knot (knottin) affinity scaffolds (Silverman, Levin, et al.,2009) are screened for those displaying binding affinity toerythrocytes.

Library screening to discover high-affinity DNA/RNA aptamers towardserythrocytes is conducted using the well-established SystematicEvolution of Ligands by Exponential Enrichment (SELEX) method (Archemix,Cambridge, Mass., USA) (Sampson, 2003). Upon discovery of novel DNA/RNAsequences that binds erythrocytes with high affinity, they arechemically synthesized to include an additional chemical reactive groupon either their 3′ or 5′ terminus for conjugation to an antigen and/orpolymer micelle/nanoparticle. The chemically synthesized aptamer does,for example, harbor a reactive NH2 group, that is conjugated via EDC/NHSconjugation chemistry with the COOH groups present on either thenanoparticle or antigen or nanoparticle-antigen complex, to create asingle bioconjugate comprising of the erythrocyte-binding aptamer andthe antigen or antigen-nanoparticle. Various chemical conjugationtechniques are attempted by altering orthogonal reactive groups andconjugation schemes on both the aptamer, antigen, and/orantigen-nanoparticle.

In order to demonstrate the induction of tolerance towards OVA, theOVA-aptamer or OVA-nanoparticle-aptamer conjugate is administered eitherintravenously or extravascularly to mice. At a predetermined number ofdays following administration, mice are sacrificed and lymph nodes,spleen, and blood are harvested for analysis. Splenocytes and lymph nodederived cells are plated and re-stimulated for 3 days ex vivo with OVAand/or SIINFEKL peptide (SEQ ID NO:3), and their down-regulation ofIFNγ, IL-17a, IL-2, and IL-4 expression, and up-regulation of TGF-β1,which are established evidence of tolerance, is measured by ELISA.Intracellular staining of IFNγ, IL-17a, IL-2, and IL-4 is performedusing flow cytometry on splenocytes and lymph node derived cellsfollowing 6 h of ex vivo re-stimulation with OVA and/or SIINFEKL (SEQ IDNO:3) peptide. Furthermore, flow cytometry is used to characterize theexpression profiles of CD4, CD8, and regulatory T-cells from lymph node,spleen, and blood derived cells. Additionally, blood samples are takenfrom mice at varying time points to measure humoral antibody responsestowards the OVA antigen. A variant experiment of the ex vivore-stimulation is performed to determine if systemic tolerance has beenestablished. Mice are administered with OVA-antibody orOVA-antibody-nanoparticle conjugate as described above, OVA isre-administered 9 days later with an adjuvant (lipopolysaccharide,complete Freud's adjuvant, alum, or other), and splenocyteresponsiveness to the OVA antigen is assessed by ELISA and/or flowcytometry as described above. The OVA-antibody and/orOVA-antibody-nanoparticle formulations are expected to rendersplenocytes non-responsive to the second challenge with OVA andadjuvant, thereby illustrating effective establishment of systemictolerance. Following initial administration with the OVA-aptamer and/orOVA-aptamer-nanoparticle formulations, similar in vivo challengeexperiments will be conducted with transgenic cell lines to demonstratetolerance, such as adoptive transfer with OT-I T cells, similar tostudies described in detail in Example 14. To demonstrate immunetolerance in mouse models of autoimmunity or deimmunization oftherapeutic molecules, analogous aptamer constructs are made to therelevant antigens as was described here with OVA.

Example 20 Characterizing of Binding to Human Erythrocytes

To characterize the selected bacterially displayed peptides that boundto human erythrocytes in a non-cell displayed context, the peptides weresynthesized chemically and conjugated to the fluorescent proteinallophycocyanin (APC). In this manner, the erythrocyte-binding capacityof each peptide was characterized in a soluble context, i.e. as aprotein conjugate. As demonstrated in FIG. 18, peptides ERY64, ERY123,and ERY141 bound to human erythrocytes as conjugates of APC

APC-Peptide Conjugation Method

Peptides were ordered and custom-synthesized via standard fmocsolid-phase peptide synthesis from PolyPeptide Group (Strasbourg,France). 10 equivalents of peptide dissolved in 3 M guanidine-HCl wereadded to 2 mg/mL maleimide-activated APC (InnovaBiosciences, Cambridge,UK) in PBS. Following a 4 h incubation at 4° C., the reaction wasdesalted on a 2 mL ZEBA Desalting Column (Thermo Scientific) and storedat 4° C.

Quantification of Erythrocyte Binding by Flow Cytometry Method

Freshly isolated human blood was dissolved 100-fold into PBSsupplemented with 20 mg/mL BSA. 5×10⁵ erythrocytes were added to 150 μLof 1 μM APC-peptide conjugate and incubated at 37 C for 45 min. Cellswere washed extensively in PBS+20 mg/mL BSA, and analyzed for APCfluorescence on a CyAn ADP Flow cytometer (Beckman Coulter).

Example 21 Inducing Antigen-Specific Immunological Tolerance ThroughErythrocyte-Binding with Single Chain Antibody-Fused Antigen

A recombinant fusion of an scFv to the MHC-I immunodominant domain ofOVA, SIINFEKL was created. The resultant scFv (herein termedTER119-SIINFEKL) bound mouse erythrocytes, as demonstrated by flowcytometry in FIG. 19.

Since ERY1-OVA has already been shown herein to induce this tolerance,it is a useful system to characterize immunological events. It wasdetermined that erythrocyte binding of ERY1-OVA led to efficientcross-presentation of the OVA immunodominant MHC I epitope (SIINFEKL) byantigen presenting cells (APCs) and corresponding cross-priming ofreactive T cells. CFSE-labeled OT-I CD8⁺ T cells (CD45.2⁺) wereadoptively transferred into CD45.1⁺ mice, and then proliferation of theOT-I CD8⁺ T cells over 5 days was measured following intravenousadministration of 10 μg of OVA, 10 μg ERY1-OVA, an equimolar dose ofTER119-SIINFEKL, or an equimolar dose of SIINFEKL. OT-I CD8⁺ T cellproliferation, determined by dilution of the fluor CFSE as measured byflow cytometry, was markedly enhanced in mice administeredTER119-SIINFEKL compared to ERY1-OVA or OVA (FIG. 20), demonstratingthat erythrocyte-binding increased antigen-specific CD8⁺ T cellcross-priming compared to the soluble antigen SIINFEKL.

To distinguish T cells being expanded into a functional effectorphenotype from those being expanded and deleted, the proliferating OT-ICD8⁺ T cells were analyzed for annexin-V, as a hallmark of apoptosis andthus deletion, as well as the exhaustion marker programmed death-1(PD-1). TER 119-SIINFEKL and ERY1-OVA induced much higher numbers ofannexin-V⁺ and PD-1⁺ proliferating OT-I CD8⁺ T cells than OVA (FIG. 21).

Using an established OT-I challenge-to-tolerance model (Liu, Iyoda, etal., 2002), the ability of TER119-SIINFEKL and ERY1-OVA to preventsubsequent immune responses to vaccine-mediated antigen challenge weredemonstrated—even with a challenge involving a very strongbacterially-derived adjuvant. To tolerize, 10 μg of either OVA orERY1-OVA, or an equimolar dose of TER119-SIINFEKL were intravenouslyadministered at 1 and 6 days following adoptive transfer of OT-I CD8⁻(CD45.2⁺) T cells to CD45.1⁺ mice. After 9 additional days to allowpotential deletion of the transferred T cells, the recipient mice werethen challenged with OVA adjuvanted with lipopolysaccharide (LPS) byintradermal injection. Characterization of draining lymph node andspleen cells as well as their inflammatory responses 4 d after challengeallowed a determination as to whether or not deletion actually tookplace.

Intravenous administration of TER119-SIINFEKL or ERY1-OVA resulted inprofound reductions in OT-I CD8⁺ T cell populations in the draininglymph nodes and spleens compared with mice administered unmodified OVAprior to antigen challenge with LPS, demonstrating deletional tolerance.Draining lymph nodes from ERY1-OVA-treated mice contained over 11-foldfewer OT-I CD8⁺ T cells as compared to OVA-treated mice, and 39-foldfewer than challenge control mice that did not receive intravenousinjections of antigen; responses in spleen cells were similar. Draininglymph nodes from TER119-SIINFEKL-treated mice contained over 13-foldfewer OT-I CD8⁺ T cells as compared to OVA-treated mice, and over42-fold fewer than challenge control mice that did not receiveintravenous injections of antigen; responses in spleen cells weresimilar. This effective clonal deletion exhibited in mice administeredTER119-SIINFEKL or ERY1-OVA supported the earlier observations ofenhanced OT-I CD8⁺ T cell cross-priming (FIG. 20) and furthermore showsthat cross-priming occurred in the absence of APC presentation ofco-stimulatory molecules to lead to deletional tolerance.

To further evaluate the immune response following antigen challenge, theinflammatory nature of resident lymph node and spleen cells wascharacterized by expression of interferon-γ (IFNγ) by OT-I CD8⁺ T cells(FIG. 22). Following challenge with OVA and LPS, the lymph nodes of micepreviously treated with ERY1-OVA harbored 10-fold fewer IFNγ-expressingcells compared to challenge control mice (previously receiving noantigen), and over 4-fold fewer IFNγ-expressing cells compared to micepreviously treated with an equivalent dose of OVA. Following challengewith OVA and LPS, the lymph nodes of mice previously treated withTER119-SIINFEKL harbored 33-fold fewer IFNγ-expressing cells compared tochallenge control mice (previously receiving no antigen), and over14-fold fewer IFNγ-expressing cells compared to mice previously treatedwith an equivalent dose of OVA, demonstrating the importance oferythrocyte binding in tolerogenic protection to challenge; responses inspleen cells were similar.

Animal Methods

Swiss Veterinary authorities previously approved all animal procedures.C57BL/6-Tg(TcraTcrb) 1100 Mjb (OT-I) mice (Jackson Labs) were bred atthe EPFL Animal Facility, and females were used for splenocyte isolationat 6-12 wk old. 8-12 week old female B6.SJL-Ptprc^(a)Pepc^(b)/Boy(CD45.1) mice (Charles River) were used as recipient hosts for OT-I CD8⁺T cell adoptive transfer and tolerance induction studies.

Peptide Design and Synthesis Methods

The ERY1 (H₂N-WMVLPWLPGTLDGGSGCRG-CONH₂) peptide (SEQ ID NO:134) wassynthesized using standard solid-phase f-moc chemistry using TGR resin(Nova Biochem) on an automated liquid handler (Chemspeed). Theunderlined sequence is the ERY1 12-mer sequence that we previouslydiscovered by phage display as a mouse glycophorin-A binder (Kontos andHubbell, 2010). The GGSG region served as a linker to the cysteineresidue used for conjugation; the flanking arginine residue served tolower the pKa and thus increase the reactivity of the cysteine residue(Lutolf, Tirelli, et al., 2001). The peptide was cleaved from the resinfor 3 h in 95% tri-fluoroacetic acid, 2.5% ethanedithiol, 2.5% water,and precipitated in ice-cold diethyl ether. Purification was conductedon a preparative HPLC-MS (Waters) using a C18 reverse phase column(PerSpective Biosystems).

ERY1-Antigen Conjugation Methods

10 molar equivalents ofsuccinimidyl-4-(N-maleimidomethyl)cyclohexane-1-carboxylate (SMCC, CAS#64987-85-5, Thermo Scientific) dissolved in dimethylformamide werereacted with 5 mg/mL endotoxin-free (<1 EU/mg) OVA (Hyglos GmbH) in PBSfor 1 h at room temperature. Following desalting on a 2 mL ZEBA Desaltspin column (Thermo Scientific), 10 equivalents of ERY1 peptidedissolved in 3 M guanidine-HCl were added and allowed to react for 2 hat room temperature. The conjugate was desalted using 2 mL Zeba Desaltspin columns, 0.2 μm sterile filtered, dispensed into working aliquots,and stored at −20 C. Protein concentration was determined via BCA Assay(Thermo Scientific). The scheme results in conjugation of the cysteineside chain on the peptide to lysine side-chains on the antigen.

T Cell Adoptive Transfer Methods

CD8⁺ T cells from OT-I (CD45.2⁺) mouse spleens were isolated using a CD8magnetic bead negative selection kit (Miltenyi Biotec) as per themanufacturer's instructions. Freshly isolated CD8⁺ OT-I cells wereresuspended in PBS and labeled with 1 μM carboxyfluorescein succinimidylester (CF SE, Invitrogen) for 6 min at room temperature, and thereaction was quenched for 1 min with an equal volume of IMDM with 10%FBS (Gibco). Cells were washed, counted, and resuspended in pure IMDMprior to injection. 3×10⁶ CFSE-labeled CD8⁺ OT-I cells were injectedintravenously into the tail vein of recipient CD45.1⁺ mice. Forshort-term proliferation studies, 10 μg of ERY1-OVA or OVA, or anequimolar dose of TER119-SIINFEKL in 100 μL volume was injected 24 hfollowing adoptive transfer. Splenocytes were harvested 5 d followingantigen administration and stained for analysis by flow cytometry.

OT-I Tolerance and Challenge Model Methods

3×10⁵ CFSE-labeled OT-I CD8⁺ T cells were injected into CD45.1⁺recipient mice as described above. 1 and 6 d following adoptivetransfer, mice were intravenously administered 10 μg of ERY1-OVA or OVA,or an equimolar dose of TER119-SIINFEKL in 100 μL saline into the tailvein. 15 d following adoptive transfer, mice were challenged with 5 μgOVA and 25 ng ultra-pure Escherichia coli LPS (InvivoGen) in 25intradermally into each rear leg pad (Hock method, total dose of 10 μgOVA and 50 ng LPS). Mice were sacrificed 4 d following challenge, andspleen and draining lymph node cells were isolated for restimulation.For flow cytometry analysis of intracellular cytokines, cells wererestimulated in the presence of 1 mg/mL OVA or 1 μg/mL SIINFEKL peptide(Genscript) for 3 h. Brefeldin-A (Sigma, 5 μg/mL) was added andrestimulation resumed for an additional 3 h prior to staining and flowcytometry analysis.

Antibodies and Flow Cytometry Methods

The following anti-mouse antibodies were used for flow cytometry: CD1dPacific Blue, CD3ε PerCP-Cy5.5, CD8α PE-Cy7, CD45.2 Pacific Blue,IFNγ-APC, CD8α APC-eF780, (all from eBioscience), in addition to fixablelive/dead dye (Invitrogen), and annexin-V-Cy5 labeling kit (BioVision).Samples were analyzed on a CyAn ADP flow cytometer (Beckman Coulter).Cells were washed first with PBS, stained for 20 min on ice withlive/dead dye, blocked for 20 min on ice with 24G2 hybridoma medium,surface stained for 20 min on ice, fixed in 2% paraformaldehyde for 20min ice, intracellularly stained in the presence of 0.5% saponin for 45min on ice, followed by a final wash prior to analysis. For apoptosisstaining, annexin-V-Cy5 was added 5 min prior to analysis.

Example 22 Creation of Antigen-Specific Immunological Tolerance TowardsTherapeutic Proteins Through Fusion Molecule of Erythrocyte BindingPeptide-and-Conjugated Antigen

A mouse erythrocyte-binding variant of asparaginase (ERY1-ASNase) wascreated by conjugating the mouse erythrocyte-specific peptide ERY1(Kontos and Hubbell, 2010). To determine the immunogenicity oferythrocyte-bound versus wild-type asparaginase, a study was performedto evaluate to evaluate two regimens, namely exposure to a 2-dose and a6-dose regimen of the ERY conjugate (ERY1-ASNase) or the native form(ASPARAGINASE MEDAC, Medac GmbH; which was also used as the raw materialfor the ERY1-ASNase conjugate). In each regimen, 15 μg of ERY1-ASNase orASNase was administered intravenously every 2 days, and blood was drawnevery 7 days.

Following the exposures at therapeutic doses, antibody titers weremeasured at various time points, up to 21 days following the finalinjection. The result is clear in showing vast reduction inimmunogenicity through erythrocyte conjugation, with no antibodiesobservable at all in the 2-dose regimen and the 6-dose regimen series(FIG. 23). By contrast, the wild type, native asparaginase (as currentlyused clinically, in the product ASPARAGINASE MEDAC), induced vigorousimmunity even following the 2 dose regimen.

A prophylaxis study was performed to determine if erythrocyte-bindingasparaginase induced bona-fide immune tolerance towards wild-typeasparaginase. Mice previously administered with wild-type clinicalasparaginase were challenged with an additional dose following the onsetof humoral immunity. Antibody levels increased or remained highfollowing re-administration of the protein; this is representative of adangerous clinical situation of hypersensitivity and shock reactionstowards the therapeutic. Mice previously treated with ERY1-conjugatedasparaginase failed to induce potent antibody responses even after sixchallenges with wild-type asparaginase. On average, mice tolerized witherythrocyte-binding asparaginase developed approx. 6000-fold fewerantibodies towards clinical wild-type asparaginase.

ERY1-ASNase Conjugation Method

10 molar equivalents ofsuccinimidyl-4-(N-maleimidomethyl)cyclohexane-1-carboxylate (SMCC, CAS#64987-85-5, Thermo Scientific) dissolved in dimethylformamide werereacted with 5 mg/mL Asparaginase Medac in PBS for 2 h at roomtemperature. Following desalting on a 2 mL ZEBA Desalt spin column(Thermo Scientific), 2.5 equivalents of ERY1 peptide dissolved in 3 Mguanidine-HCl were added and allowed to react for 2 h at roomtemperature. The conjugate was desalted using 2 mL Zeba Desalt spincolumns, 0.2 μm sterile filtered, dispensed into working aliquots, andstored at −20 C. Protein concentration was determined via BCA Assay(Thermo Scientific). The scheme results in conjugation of the cysteineside chain on the peptide to lysine side-chains on the protein.

Flow Cytometry Detection of Binding Method

Freshly isolated human blood was diluted 100-fold into PBS supplementedwith 20 mg/mL BSA. Approximately 500,000 erythrocytes were added to 100nM of asparaginase and incubated at 37 C for 1 h. Following washing,cells were incubated with goat anti-asparaginase (Abnova) for 30 min onice. Following a second round of washing, cells were incubated withALEXAFLUOR488-conjugated anti-goat IgG antibody (Invitrogen) for 20 minon ice. After a final wash, cells were analyzed on a flow cytometer todetect for erythrocyte-bound asparaginase.

Asparaginase Administration Method

Desired dosages of ERY1-ASNase or ASNase were prepared in sterile 0.9%saline, and 100 μL of the solution was injected into the tail vein ofanesthetized C57BL/6 mice. Blood was drawn at pre-determined time pointseither by cheek puncture or tail incisions.

Anti-asparaginase antibody detection from serum method Serum fromexperimental groups was serially diluted into PBS and incubated for 2 hat RT on ASNase-coated ELISA plates. HRP-conjugated anti-mouse IgG(Southern Biotech) was used as the detection antibody.

Example 23 Immune Reversal to Create Tolerance after Immunoreaction

In the clinical case where immunity (exemplified by the presence ofanti-drug-antibodies) towards a therapeutic protein or protein ofinterest has already been induced in the patient, it is desirable toreverse the immune response towards the drug, thus enabling further useof the therapeutic. Again, the clinically available microbial enzymeasparaginase was used in this example to demonstrate the induction oftolerance towards a therapeutic protein in mice with pre-existingimmunity towards asparaginase. A mouse erythrocyte-binding variant ofasparaginase (ERY1-ASNase) was created by conjugating the mouseerythrocyte-specific peptide ERY1.

A cross-over study was performed to determine if erythrocyte-bindingasparaginase could reverse immunity towards clinical asparaginase. Micewere intravenously administered multiple doses of wild-type asparaginasetwo days apart. 21 days following administration, high levels ofanti-asparaginase antibodies were detected in serum. Immunized mice werethen therapeutically treated with erythrocyte-binding asparaginaseregimens at varying doses. In both dosing regimens, ERY-conjugatedasparaginase reduced antibody levels approx. 10-fold, thus reversingpre-existing humoral immunity

ERY1-ASNase Conjugation Method

10 molar equivalents ofsuccinimidyl-4-(N-maleimidomethyl)cyclohexane-1-carboxylate (SMCC, CAS#64987-85-5, Thermo Scientific) dissolved in dimethylformamide werereacted with 5 mg/mL ASPARAGINASE MEDAC in PBS for 2 h at roomtemperature. Following desalting on a 2 mL ZEBA Desalt spin column(Thermo Scientific), 2.5 equivalents of ERY1 peptide dissolved in 3 Mguanidine-HCl were added and allowed to react for 2 h at roomtemperature. The conjugate was desalted using 2 mL ZEBA Desalt spincolumns, 0.2 μm sterile filtered, dispensed into working aliquots, andstored at −20 C. Protein concentration was determined via BCA Assay(Thermo Scientific). The scheme results in conjugation of the cysteineside chain on the peptide to lysine side-chains on the protein.

Flow Cytometry Detection of Binding Method

Freshly isolated human blood was diluted 100-fold into PBS supplementedwith 20 mg/mL BSA. Approximately 500,000 erythrocytes were added to 100nM of asparaginase and incubated at 37 C for 1 h. Following washing,cells were incubated with goat anti-asparaginase (Abnova) for 30 min onice. Following a second round of washing, cells were incubated withALEXAFLUOR488-conjugated anti-goat IgG antibody (Invitrogen) for 20 minon ice. After a final wash, cells were analyzed on a flow cytometer todetect for erythrocyte-bound asparaginase.

Asparaginase Administration Method

Desired dosages of ERY1-ASNase or ASNase were prepared in sterile 0.9%saline, and 100 μL of the solution was injected into the tail vein ofanesthetized C57BL/6 mice. Blood was drawn at pre-determined time pointseither by cheek puncture or tail incisions.

Anti-Asparaginase Antibody Detection from Serum Method

Serum from experimental groups was serially diluted into PBS andincubated for 2 h at RT on ASNase-coated ELISA plates. HRP-conjugatedanti-mouse IgG (Southern Biotech) was used as the detection antibody.

Example 24 Development of Antibodies and Antibody-Fragments that BindMouse and/or Human Erythrocytes

Several erythrocyte binding antigen constructs have been created. Theseinclude those relating to the protein level: TER119-SIINFEKL,TER119-ChrA, and TER119-proinsulin. These also include those relating tothe genetic level: TER119-SIINFEKL, TER119-ChrA TER119-proinsulin,TER119-uricase, TER119-InsB9-23, TER119-ISQAVHAAHAEINEAGR (SEQ IDNO:87), TER119-H-2kb, TER119-H-2kd, 10F7-SIINFEKL, 10F7-ChrA,10F7-proinsulin, and 10F7-uricase.

Methods

mRNA from the TER-119 hybridoma clone was obtained as a gift from Prof.Shozo Izui at the University of Geneva, Switzerland. Standard reversetranscriptase PCR (RT-PCR) was performed using the SUPERSCRIPT III FIRSTSTRAND SYNTHESIS SYSTEM (Invitrogen) to create complimentary DNA (cDNA)of the clone. PCR was then conducted using the following set of primersto specifically amplify the DNA sequences of the variable heavy (VH) andvariable light (VL) regions of the antibody:

Primer SEQ ID name Primer sequence (5′ to 3′) NO VL-AGC CGG CCA TGG CGG AYA TCC AGC TGA SEQ ID  FOR1 CTC AGC C NO: 88 VL-AGC CGG CCA TGG CGG AYA TTG TTC TCW SEQ ID  FOR2 CCC AGT C NO: 89 VL-AGC CGG CCA TGG CGG AYA TTG TGM TMA SEQ ID  FOR3 CTC AGT C NO: 90 VL-AGC CGG CCA TGG CGG AYA TTG TGY TRA SEQ ID  FOR4 CAC AGT C NO: 91 VL-AGC CGG CCA TGG CGG AYA TTG TRA TGA SEQ ID  FOR5 CMC AGT C NO: 92 VL-AGC CGG CCA TGG CGG AYA TTM AGA TRA SEQ ID  FOR6 MCC AGT C NO: 93 VL-AGC CGG CCA TGG CGG AYA TTC AGA TGA SEQ ID  FOR7 YDC AGT C NO: 94 VL-AGC CGG CCA TGG CGG AYA TYC AGA TGA SEQ ID  FOR8 CAC AGA C NO: 95 VL-AGC CGG CCA TGG CGG AYA TTG TTC TCA SEQ ID  FOR9 WCC AGT C NO: 96 VL-AGC CGG CCA TGG CGG AYA TTG WGC TSA SEQ ID  FOR10 CCC AAT C NO: 97 VL-AGC CGG CCA TGG CGG AYA TTS TRA TGA SEQ ID  FOR11 CCC ART C NO: 98 VL-AGC CGG CCA TGG CGG AYR TTK TGA TGA SEQ ID  FOR12 CCC ARA C NO: 99 VL-AGC CGG CCA TGG CGG AYA TTG TGA TGA SEQ ID  FOR13 CBC AGK C NO: 100 VL-AGC CGG CCA TGG CGG AYA TTG TGA TAA SEQ ID  FOR14 CYC AGG A NO: 101 VL-AGC CGG CCA TGG CGG AYA TTG TGA TGA SEQ ID  FOR15 CCC AGW T NO: 102 VL-AGC CGG CCA TGG CGG AYA TTG TGA TGA SEQ ID  FOR16 CAC AAC C NO: 103 VL-AGC CGG CCA TGG CGG AYA TTT TGC TGA SEQ ID  FOR17 CTC AGT C NO: 104 VL-AGC CGG CCA TGG CGG ARG CTG TTG TGA SEQ ID  FOR18 CTC AGG AAT C NO: 105VL- GAT GGT GCG GCC GCA GTA CGT TTG ATT SEQ ID  REV1 TCC AGC TTG GNO: 106 VL- GAT GGT GCG GCC GCA GTA CGT TTT ATT SEQ ID  REV2TCC AGC TTG G NO: 107 VL- GAT GGT GCG GCC GCA GTA CGT TTT ATT SEQ ID REV3 TCC AAC TTT G NO: 108 VL- GAT GGT GCG GCC GCA GTA CGT TTC AGCSEQ ID  REV4 TCC AGC TTG G NO: 109 VL-GAT GGT GCG GCC GCA GTA CCT AGG ACA SEQ ID  REV5 GTC AGT TTG G NO: 110VL- GAT GGT GCG GCC GCA GTA CCT AGG ACA SEQ ID  REV6 GTG ACC TTG GNO: 111 VH- GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR1GGC GGA KGT RMA GCT TCA GGA GTC NO: 100 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR2GGC GGA GGT BCA GCT BCA GCA GTC NO: 112 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR3GGC GCA GGT GCA GCT GAA GSA STC NO: 113 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR4GGC GGA GGT CCA RCT GCA ACA RTC NO: 114 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR5GGC GCA GGT YCA GCT BCA GCA RTC NO: 115 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR6GGC GCA GGT YCA RCT GCA GCA GTC NO: 116 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR7GGC GCA GGT CCA CGT GAA GCA GTC NO: 117 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR8GGC GGA GGT GAA SST GGT GGA ATC NO: 118 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR9GGC GGA VGT GAW GYT GGT GGA GTC NO: 119 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR10GGC GGA GGT GCA GSK GGT GGA GTC NO: 120 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR11GGC GGA KGT GCA MCT GGT GGA GTC NO: 121 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR12GGC GGA GGT GAA GCT GAT GGA RTC NO: 122 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR13GGC GGA GGT GCA RCT TGT TGA GTC NO: 123 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR14GGC GGA RGT RAA GCT TCT CGA GTC NO: 124 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR15GGC GGA AGT GAA RST TGA GGA GTC NO: 125 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR16GGC GCA GGT TAC TCT RAA AGW GTS TG NO: 126 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR17GGC GCA GGT CCA ACT VCA GCA RCC NO: 127 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR18GGC GGA TGT GAA CTT GGA AGT GTC NO: 128 VH-GTT ATT GCT AGC GGC TCA GCC GGC AAT SEQ ID  FOR19GGC GGA GGT GAA GGT CAT CGA GTC NO: 129 VH-CCC TTG AAG CTT GCT GAG GAA ACG GTG SEQ ID  REV1 ACC GTG GT NO: 130 VH-CCC TTG AAG CTT GCT GAG GAG ACT GTG SEQ ID  REV2 AGA GTG GT NO: 131 VH-CCC TTG AAG CTT GCT GCA GAG ACA GTG SEQ ID  REV3 ACC AGA GT NO: 132 VH-CCC TTG AAG CTT GCT GAG GAG ACG GTG SEQ ID  REV4 ACT GAG GT NO: 133

The amplified VH and VL genes were then digested with restrictionendonucleases (NcoI and NotI for VL, NdeI and HindIII for VH), the genefragments were purified following agarose electrophoresis using astandard kit (Zymo Research, Orange, Calif., USA), and ligated into acloning plasmid pMAZ360. The cloning plasmid was then sequenced todetermine the DNA sequence of the VH and VL genes of TER119.

TER119 and 10F7-antigen DNA constructs were designed and commerciallysynthesized and obtained from DNA2.0 (Menlo Park, Calif., USA).

Each final completed scFv gene was digested with SfiI and XhoI (NEB,Ipswich, Mass., USA), and ligated into the same sites on the pSecTagAmammalian expression plasmid (Invitrogen, Carlsbad, Calif, USA).

Example 25 Induction of Tolerance Towards Diabetogenic Antigens UsingErythrocyte-Binding Diabetes Antigens

Chromogranin-A mimotope peptide (termed 1040-p31 or ChrA) was engineeredto bind to mouse erythrocytes by recombinantly fusing the peptide to themouse erythrocyte-specific scFv TER119. The resultant scFv, hereintermed TER119-ChrA, tightly bound mouse erythrocytes (data not shown).To study T cell behavior towards the chromogranin-A antigen variants,the NODBDC2.5 transgenic mouse was used, which harbors T cells specificfor the recognition of the chromogranin-A antigen. To determine ifTER119-ChrA was processed and displayed on major histocompatibility-II(MHC-II) complexes in a manner sufficient for BDC2.5 T cell priming, theantigen was added to a co-culture system with BDC2.5 splenic dendriticcells and CD4 T cells. As demonstrated in FIG. 24, TER119-ChrA wasefficiently processed and the correct antigenic domain displayed onMHC-II to prime antigen-specific proliferation of the transgenic BDC2.5CD4 T cells in vitro, which is a requisite for T cell tolerance in vivo.

To determine the consequences of erythrocyte binding of the autoantigenon CD4 proliferation in vivo, a similar proliferation study wasconducted using BDC2.5 CD4 T cells labeled with the fluorescent moleculeCFSE. Following adoptive transfer of the labeled BDC2.5 CD4 T cells intonaïve NOD mice, either 10 μg of TER119-ChrA or an equimolar dose of freesoluble 1040-p31 peptide was administered intravenously. As isdemonstrated in FIG. 25, mice treated with TER119-ChrA harbored farfewer non-proliferating BDC2.5 CD4 T cells in both the spleen andpancreatic lymph nodes (pLN) compared with mice treated with the soluble1040-p31 peptide. These data demonstrate that erythrocyte-bindingantigen drives potent antigen-specific CD4 T cell signaling and primingin a manner functionally distinct from soluble antigen, similar to theinventors thorough investigations of CD8 T cell deletional tolerance.Such marked reduction in systemic (spleen) and local (pancreatic lymphnode) diabetogenic T cells is clear positive indication of a favorableoutcome for control of disease onset.

Example 26 Induction of Tolerance Towards Insulin

As already demonstrated herein (for instance, see Example 25), tolerancecan be created towards various antigens. This example describes howtolerance to insulin can be created. In order to induce tolerancetowards insulin, which is another islet antigen recognized bydiabetogenic T cells, insulin is engineered to bind mouse erythrocytesby recombinant fusion to the mouse erythrocyte-specific scFv TER119. Theresultant scFv, herein termed TER119-proinsulin, is implemented in theconventional mouse model of spontaneous onset T1D, namely the NOD/ShiLtmouse. The NOD/ShiLt mouse spontaneously undergoes immune cell mediateddestruction of insulin-producing pancreatic tissue, thus inducinghyperglycemia and clinical onset of disease. Similarly, human insulinand human erythrocyte binding factors may be used to create tolerance toinsulin in humans.

To demonstrate tolerance in this robust spontaneously autoimmune mousemodel, TER119-proinsulin is to be administered to young (˜3 week old)mice at varying time intervals and doses in order to functionallyinactivate and/or delete insulin-reactive T cells. Glucose levels of thetreated mice are monitored to assess hyperglycemia and clinical onset ofdisease. TER119-proinsulin is also used in a therapeutic mode to induceremission of disease. In such a study, TER119-proinsulin is administeredto new-onset hyperglycemic mice at varying doses and time intervals, andglucose levels are monitored to assess reduction of hyperglycemia andreturn to homeostasis, thus demonstrating remission of clinical onset ofT1D.

Example 27 Creating Tolerance Towards Cellular Grafts and Transplants byUsing Erythrocyte-Binding MHC Molecules

A process of creating tolerance of grafts is provided by way of example.Erythrocyte-binding MHC molecules are engineered by chemicallyconjugating erythrocyte-binding peptides to soluble MHC domains.Alternatively, the MHC molecule may be recombinantly expressed as afusion with an erythrocyte-specific scFv.

In order to demonstrate tolerance towards MHC molecules by erythrocytebinding, mouse models of cellular grafting, such as tumor grafts, skingrafts, islet transplants, and hematopoietic cell transplants areconducted. In each study, the host mouse is tolerized towards the donorMHC class by administration of erythrocyte-binding MHC prior to orduring the graft procedure. Graft acceptance is monitored using methodsappropriate for each study; i.e., measurement of tumor growth in tumorgrafts, monitoring tissue necrosis or growth in skin transplant,monitoring islet mass and glycemia in islet transplants, andcharacterizing chimerism in hematopoietic cell transplants.

FURTHER DISCLOSURE

Various embodiments of the invention are described. An embodiment is anisolated peptide comprising at least 5 consecutive amino acid residuesof a sequence chosen from the group consisting of SEQ ID NO:11, SEQ IDNO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID NO:17, SEQ IDNO:1, and conservative substitutions thereof, wherein said sequencespecifically binds an erythrocyte. An embodiment is the peptide with oneor more residues with a D to L substitution or has a conservativesubstitution of at least one and no more than two amino acids of thesequences chosen from the group consisting of SEQ ID NO:11, SEQ IDNO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID NO:17, and SEQID NO:1. An embodiment is the peptide with at least 5 consecutive aminoacid residues of a sequence chosen from the group consisting of SEQ IDNO:11, SEQ ID NO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ IDNO:17, SEQ ID NO:1, and conservative substitutions thereof, wherein saidsequence specifically binds an erythrocyte. The peptide may have, e.g.,a number of residues between about 10 and about 80. The peptide mayfurther comprise a therapeutic agent, e.g., be chosen from the groupconsisting of insulin, pramlintide acetate, growth hormone, insulin-likegrowth factor-1, erythropoietin, type 1 alpha interferon, interferonα2a, interferon α2b, interferon β1a, interferon β1b, interferon γ1b,β-glucocerebrosidase, adenosine deaminase, granulocyte colonystimulating factor, granulocyte macrophage colony stimulating factor,interleukin 1, interleukin 2, interleukin 11, factor VIIa, factor VIII,factor IX, exenatide, L-asparaginase, rasburicase, tumor necrosis factorreceptor, and enfuvirtide. The peptide may be further comprising amember of the group consisting of an antibody, an antibody fragment, anda single chain antigen binding domain (ScFv). The peptide may be furthercomprising a tolerogenic antigen, e.g., chosen from the group consistingof proteins deficient by genetic disease, proteins with nonhumanglycosylation, nonhuman proteins, synthetic proteins not naturally foundin humans, human food antigens, human transplantation antigens, andhuman autoimmune antigens. The peptide may have one or more sequencesthat specifically bind an erythrocyte, the sequences may be repeats ofthe same sequence or a mix of various sequences that perform saidbinding.

An embodiment is a method of producing immunotolerance, the methodcomprising administering a composition comprising a molecular fusionthat comprises a tolerogenic antigen and an erythrocyte-binding moietythat specifically binds an erythrocyte in the patient and thereby linksthe antigen to the erythrocyte, wherein the molecular fusion isadministered in an amount effective to produce immunotolerance to asubstance that comprises the tolerogenic antigen. An embodiment is themethod wherein the molecular fusion consists of at least oneerythrocyte-binding moiety directly covalently bonded to the antigen:for instance, a fusion protein comprising the moiety and the antigen. Anembodiment is the method wherein the molecular fusion comprises at leastone erythrocyte-binding moiety attached to a particle that is attachedto or contains the antigen, e.g., wherein the particle is chosen fromthe group consisting of a microparticle, a nanoparticle, a liposome, apolymersome, and a micelle. An embodiment is the case wherein thetolerogenic antigen comprises a portion of a therapeutic protein, e.g.,the protein comprises factor VIII or factor IX. An embodiment is thecase wherein the tolerogenic antigen comprises a portion of a nonhumanprotein. An embodiment is the case wherein the protein comprisesadenosine deaminase, L-asparaginase, rasburicase, antithymocyteglobulin, L-arginase, and L-methionase. An embodiment is the methodwherein the patient is a human and the tolerogenic antigen comprises aportion of a protein not found in nature. An embodiment is the casewherein the patient is a human and the tolerogenic antigen comprises aglycan of a protein that comprises nonhuman glycosylation. An embodimentis the case wherein the tolerogenic antigen comprises at least a portionof a human transplantation antigen. An embodiment is the case whereinthe tolerogenic antigen comprises a portion of a human autoimmunedisease protein, e.g., chosen from the group consisting ofpreproinsulin, proinsulin, insulin, GAD65, GAD67, IA-2, IA-2β,thyroglobulin, thyroid peroxidase, thyrotropin receptor, myelin basicprotein, myelin oligodendrocyte glycoprotein, proteolipid protein,collagen II, collagen IV, acetylcholine receptor, matrix metalloprotein1 and 3, molecular chaperone heat-shock protein 47, fibrillin-1, PDGFreceptor α, PDGF receptor β, and nuclear protein SS-A. An embodiment isthe case wherein the tolerogenic antigen comprises a portion of a humanfood, e.g., is chosen from the group consisting of conarachin (Ara h 1),allergen II (Ara h 2), arachis agglutinin (Ara h 6), α-lactalbumin(ALA), lactotransferrin, glutein, low molecular weight glutein, α- andγ-gliadin, hordein, secalin, and avenin. An embodiment is the casewherein the erythrocyte-binding moiety is chosen from the groupconsisting of a peptide ligand, an antibody, an antibody fragment, and asingle chain antigen binding domain (ScFv). An embodiment is the casewherein the erythrocyte-binding moiety comprises an antibody, anantibody fragment or an ScFv derived from a hybridoma that produces anantibody against an erythrocyte, with the hybridoma being chosen fromthe group consisting of BRIC 4, BRIC 5, BRIC 6, BRIC 10, BRIC 14, BRIC18, BRIC 39, BRIC 66, BRIC 68, BRIC 69, BRIC 87, BRIC 108, BRIC 110,BRIC 111, BRIC 125, BRIC 126, BRIC 128, BRIC 145, BRIC 155, BRIC 157,BRIC 163, BRIC 170, BRIC 198, BRIC 203, BRIC 216, BRIC 220, BRIC 221,BRIC 222, BRIC 229, BRIC 230, BRIC 231, BRIC 235, BRIC 256, BRAC 17,BRAC 18, BGRL 1, BGRL 2, BGRL 11, BGRL 100, BRAD 3, BIRMA D6, BIRMA D10,BIRMA K3, BIRMA K3, 84B; 6A7; COE; or KZ1. An embodiment is the casewherein the erythrocyte-binding moiety specifically binds to abiomolecule chosen from the group consisting of Band 3 (CD233),aquaporin-1, Glut-1, Kidd antigen, RhAg/Rh50 (CD241), Rh (CD240), Rh30CE(CD240CE), Rh30D (CD240D), Kx, glycophorin A, glycophorin B (CD235b),glycophorin C (CD235c), glycophorin D (CD235d), Kell (CD238),Duffy/DARCi (CD234), CR1 (CD35), DAF (CD55), Globoside, CD44, ICAM-4(CD242), Lu/B-CAM (CD239), XG1/XG2 (CD99), EMMPRIN/neurothelin (CD147),JMH, Glycosyltransferase, Cartwright, Dombrock, C4A/CAB, Scianna, MER2,stomatin, BA-1 (CD24), GPIV (CD36), CD108, CD139, and H antigen (CD173).The tolerogenic antigen may comprise a mimotope. An embodiment is thecase wherein the scFv comprises some or all of 10F7, e.g., one or moreof a light chain of 10F7 and/or a heavy chain of 10F7 and/or a higheraffinity variant of a light chain of 10F7 and/or a heavy chain of 10F7.An embodiment is the method wherein the erythrocyte-binding moietycomprises a peptide ligand comprising at least 5 consecutive amino acidresidues of a sequence chosen from the group consisting of SEQ ID NO:11,SEQ ID NO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ ID NO:16, SEQ ID NO:17,SEQ ID NO:1, and conservative substitutions thereof, wherein saidsequence specifically binds an erythrocyte.

An embodiment is a composition comprising a molecular fusion thatcomprises a tolerogenic antigen and an erythrocyte-binding moiety thatspecifically binds an erythrocyte in the patient and thereby links theantigen to the erythrocyte. An instance is the case wherein theerythrocyte-binding moiety is covalently bonded to the antigen. Anotherinstance is the case wherein the molecular fusion comprises theerythrocyte-binding moiety attached to a particle that is attached tothe antigen, .e.g, a microparticle, a nanoparticle, a liposome, apolymersome, or a micelle. Examples of a tolerogenic antigen are: aportion of a therapeutic protein, s a portion of a nonhuman protein, aportion (including the whole portion, i.e., all) of a protein notnaturally found in a human, a glycan of a protein that comprisesnonhuman glycosylation, a portion of a human autoimmune antigen, aportion of a human food. An embodiment is the composition wherein theerythrocyte-binding moiety is chosen from the group consisting of apeptide ligand, an antibody, an antibody fragment, and a single chainantigen binding domain (ScFv), e.g., all or a portion of 10F7. Theerythrocyte-binding moiety may comprises a peptide ligand comprising atleast 5 consecutive amino acid residues of a sequence chosen from thegroup consisting of SEQ ID NO:11, SEQ ID NO:13, SEQ ID NO:14, SEQ IDNO:15, SEQ ID NO:16, SEQ ID NO:17, SEQ ID NO:1, and conservativesubstitutions thereof, wherein said sequence specifically binds anerythrocyte. The erythrocyte-binding moiety may be one that comprises apeptide ligand that has a dissociation constant of between about 10 μMand 0.1 nM as determined by equilibrium binding measurements between thepeptide and erythrocytes. An embodiment is the case wherein theerythrocyte-binding moiety comprises an antibody, an antibody fragmentor an ScFv derived from a hybridoma that produces an antibody against anerythrocyte, with the hybridoma being chosen from the group consistingof BRIC 4, BRIC 5, BRIC 6, BRIC 10, BRIC 14, BRIC 18, BRIC 39, BRIC 66,BRIC 68, BRIC 69, BRIC 87, BRIC 108, BRIC 110, BRIC 111, BRIC 125, BRIC126, BRIC 128, BRIC 145, BRIC 155, BRIC 157, BRIC 163, BRIC 170, BRIC198, BRIC 203, BRIC 216, BRIC 220, BRIC 221, BRIC 222, BRIC 229, BRIC230, BRIC 231, BRIC 235, BRIC 256, BRAC 17, BRAC 18, BGRL 1, BGRL 2,BGRL 11, BGRL 100, BRAD 3, BIRMA D6, BIRMA D10, BIRMA K3, BIRMA K3, 84B;6A7; COE; or KZ1. An embodiment is the case wherein theerythrocyte-binding moiety specifically binds to a biomolecule chosenfrom the group consisting of Band 3 (CD233), aquaporin-1, Glut-1, Kiddantigen, RhAg/Rh50 (CD241), Rh (CD240), Rh30CE (CD240CE), Rh30D(CD240D), Kx, glycophorin A, glycophorin B (CD235b), glycophorin C(CD235c), glycophorin D (CD235d), Kell (CD238), Duffy/DARCi (CD234), CR1(CD35), DAF (CD55), Globoside, CD44, ICAM-4 (CD242), Lu/B-CAM (CD239),XG1/XG2 (CD99), EMMPRIN/neurothelin (CD147), JMH, Glycosyltransferase,Cartwright, Dombrock, C4A/CAB, Scianna, MER2, stomatin, BA-1 (CD24),GPIV (CD36), CD108, CD139, and H antigen (CD173). The tolerogenicantigen may comprise a mimotope.

The tolerogenic compositions may be used in treating a pathologiccondition, for instance a pathologic condition chosen from the groupconsisting of transplant rejection, autoimmune disease, food allergy,and immune response against a therapeutic agent.

An embodiment is a pharmaceutically acceptable composition for use inimmunoreversal of an immune response against a substance comprising afusion molecule that comprises an erythrocyte-binding moiety and anantigen of the substance. The composition may have the tolerogenicantigen is chosen from, for example, the group consisting of a protein,a portion of a protein, a human protein or portion thereof, a nonhumanprotein or portion thereof, a glycan, a glycan of a protein thatcomprises nonhuman glycosylation, a human autoimmune antigen, a proteintherapeutic for a human or a portion thereof, and a portion of a humanfood. The composition may have the tolerogenic antigen is chosen from,for example, the group consisting of proteins deficient by geneticdisease, proteins with nonhuman glycosylation, nonhuman proteins,synthetic proteins not naturally found in humans, human food antigens,human transplantation antigens, and human autoimmune antigens. Theerythrocyte-binding moiety may be provides that specifically binds to abiomolecule chosen from the group consisting of Band 3 (CD233),aquaporin-1, Glut-1, Kidd antigen, RhAg/Rh50 (CD241), Rh (CD240),Rh30OCE (CD240CE), Rh30D (CD240D), Kx, glycophorin A, glycophorin B(CD235b), glycophorin C (CD235c), glycophorin D (CD235d), Kell (CD238),Duffy/DARCi (CD234), CR1 (CD35), DAF (CD55), Globoside, CD44, ICAM-4(CD242), Lu/B-CAM (CD239), XG1/XG2 (CD99), EMMPRIN/neurothelin (CD147),JMH, Glycosyltransferase, Cartwright, Dombrock, C4A/CAB, Scianna, MER2,stomatin, BA-1 (CD24), GPIV (CD36), CD108, CD139, and H antigen (CD173).The erythrocyte-binding moiety may be chosen from the group consistingof a peptide ligand, an antibody, an antibody fragment, and a singlechain antigen binding domain (ScFv). The erythrocyte-binding moiety maybe prepared so that it comprises an antibody, an antibody fragment or anScFv derived from a hybridoma that produces an antibody against anerythrocyte, with the hybridoma being chosen from the group consistingof BRIC 4, BRIC 5, BRIC 6, BRIC 10, BRIC 14, BRIC 18, BRIC 39, BRIC 66,BRIC 68, BRIC 69, BRIC 87, BRIC 108, BRIC 110, BRIC 111, BRIC 125, BRIC126, BRIC 128, BRIC 145, BRIC 155, BRIC 157, BRIC 163, BRIC 170, BRIC198, BRIC 203, BRIC 216, BRIC 220, BRIC 221, BRIC 222, BRIC 229, BRIC230, BRIC 231, BRIC 235, BRIC 256, BRAC 17, BRAC 18, BGRL 1, BGRL 2,BGRL 11, BGRL 100, BRAD 3, BIRMA D6, BIRMA D10, BIRMA K3, BIRMA K3, 84B;6A7; COE; or KZ1.

Embodiments include a fusion molecule comprising an erythrocyte-bindingmoiety and an antigen of asparaginase. As is evident from the multipledisclosures of erythrocyte-binding moieties, there are many options forthe same, including: an scFv that binds a human erythrocyte or apeptidic binding ligand chosen from the group consisting of SEQ IDNO:11, SEQ ID NO:12, SEQ ID NO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ IDNO:16, SEQ ID NO:17, and conservative substitutions thereof, whereinsaid sequence specifically binds an erythrocyte. Such a compositioncomprising the fusion molecule may be used for inducing tolerance toasparaginase.

Embodiments include a fusion molecule comprising and anerythrocyte-binding moiety and an antigen of chromogranin-A. The antigenmay be a mimotope or some or all of a chromogranin-A. As is evident fromthe multiple disclosures of erythrocyte-binding moieties, there are manyoptions for the same, including: an scFv that binds a human erythrocyteor a peptidic binding ligand chosen from the group consisting of SEQ IDNO:11, SEQ ID NO:12, SEQ ID NO:13, SEQ ID NO:14, SEQ ID NO:15, SEQ IDNO:16, SEQ ID NO:17, and conservative substitutions thereof, whereinsaid sequence specifically binds an erythrocyte. Such a compositioncomprising the fusion molecule may be used for inducing tolerance tochromogranin-A and/or for preventing diabetes or reducing progression adiabetes disease.

Another instance is a composition comprising an erythrocyte-bindingmoiety that specifically binds an erythrocyte joined to an entity chosenfrom the group consisting of a synthetic polymer, a branched syntheticpolymer, and a particle. The particle may be, e.g., a microparticle, ananoparticle, a liposome, a polymersome, and a micelle. The compositionmay further comprise a tolerogenic antigen, a therapeutic agent, or atumor homing ligand.

Embodiments include a method of embolizing a tumor in a patientcomprising administering a composition or medicament comprising thecomposition to a patient that comprises a molecular fusion of anerythrocyte-binding moiety and a tumor-homing ligand, wherein thetumor-homing ligand is an antibody, antibody fragment, a single chainantigen binding domain (ScFv), or peptide ligand that is directed tospecifically bind a target chosen from the group consisting of a tumorand tumor vasculature, and wherein the erythrocyte-binding moietycomprises a peptide ligand, an antibody, an antibody fragment, an scFv,or an aptamer that specifically binds erythrocytes. Examples of tumorhoming ligands are aminopeptidase-A, aminopeptidase -N, endosialin, cellsurface nucleolin, cell surface annexin-1, cell surface p32/ gC1qreceptor, cell surface plectin-1, fibronectin EDA, fibronectin EDB,interleukin 11 receptor α, tenascin-C, endoglin/CD105, BST-2,galectin-1, VCAM-1, fibrin and tissue factor receptor. The erythrocytemoiety may comprise, e.g., a peptide ligand, an scFv, or an antibody orfragment.

An embodiment is a single chain antigen binding domain (scFv) comprisinga peptide ligand that specifically binds an erythrocyte. The peptide maybe attached to the scFv or disposed in a linker portion. One or more ofthe peptide ligands may be included.

All patent applications, patents, and publications mentioned herein arehereby incorporated by reference herein for all purposes; in the case ofconflict, the instant specification controls.

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1. (canceled)
 2. A composition for immunomodulation to achieveantigen-specific tolerance, the composition comprising: an antigen towhich tolerance is desired; wherein the antigen is selected from thegroup consisting of proinsulin and immunogenic fragments thereof; anerythrocyte-binding moiety, wherein the erythrocyte-binding moiety hasthe ability to non-covalently, specifically bind an exterior erythrocytesurface in situ in blood, wherein the erythrocyte-binding moietypresents said antigen to the immune system of a human; wherein theerythrocyte-binding moiety comprises an antibody fragment, wherein theantigen to which tolerance is desired is recombinantly fused orchemically conjugated to the erythrocyte-binding moiety, and wherein,upon administration to a human in which tolerance to the antigen isdesired: the composition binds to CD45 negative cells, but not to CD45positive cells, and the composition reduces, fails to induce, orprevents inflammatory responses in antigen-specific T cells as comparedto when the human is exposed to the antigen alone.
 3. The composition ofclaim 2, wherein the antibody fragment is directed against glycophorinA, wherein the erythrocyte-binding moiety is derived from a 10F7 clone,wherein the administration of the composition ameliorates Type 1diabetes, and wherein the composition reduces the number of residentlymph node and spleen cells expressing interferon-gamma (IFNγ), ascompared to the number of resident lymph node and spleen cellsexpressing IFNγ when the human is exposed to the antigen alone.
 4. Thecomposition of claim 2, wherein the erythrocyte-binding moietyspecifically binds to a biomolecule selected from the group consistingof Band 3 (CD233), aquaporin-1, Glut-1, Kidd antigen, RhAg/Rh50 (CD241),Rh (CD240), Rh30CE (CD240CE), Rh30D (CD240D), Kx, glycophorin A,glycophorin B (CD235b), glycophorin C (CD235c), glycophorin D (CD235d),Kell (CD238), Duffy/DARCi (CD234), CR1 (CD35), DAF (CD55), Globoside,CD44, ICAM-4 (CD242), Lu/B-CAM (CD239), XG1/XG2 (CD99),EMMPRIN/neurothelin (CD147), JMH, Glycosyltransferase, Cartwright,Dombrock, C4A/CAB, Scianna, MER2, stomatin, BA-1 (CD24), GPIV (CD36),CD108, CD139, and H antigen (CD173).
 5. The composition of claim 2,wherein the erythrocyte-binding moiety is affinity matured, wherein theerythrocyte-binding moiety does not specifically bind to other bloodcomponents, wherein the other blood components comprises blood proteins,albumin, fibronectin, platelets, and white blood cells, wherein thebinding of the erythrocyte-binding moiety to the erythrocyte cellsurface does not alter cell morphology, wherein there is no cytoplasmictranslocation of the composition upon binding of the erythrocyte-bindingmoiety to the erythrocyte cell surface, and wherein the binding of theerythrocyte-binding moiety to the erythrocyte cell surface does notcause the erythrocytes to become apoptotic.
 6. The composition of claim2, wherein the erythrocyte-binding moiety comprises an scFv, a divalentscFv, a diabody, a triabody, or a tetrabody.
 7. The composition of claim2, wherein the erythrocyte-binding moiety is derived from a 10F7 clone.8. The composition of claim 2, wherein the antibody fragment is affinitymatured.
 9. A composition for immunomodulation to achieveantigen-specific tolerance, the composition comprising: an antigenrecombinantly fused or chemically conjugated with an erythrocyte-bindingmoiety; said antigen being recognizable by an immune system of asubject, the immune system of the subject being able to respond to theantigen with an unwanted immune response; wherein saiderythrocyte-binding moiety comprises a polypeptide; wherein uponadministration of the composition, said erythrocyte-binding moietynon-covalently and specifically binds an erythrocyte in situ in bloodand presents said antigen to the immune system of the subject; whereinthe erythrocyte-binding moiety does not specifically bind to other bloodcomponents, wherein the other blood components comprises blood proteins,albumin, fibronectin, platelets, and white blood cells; wherein saidantigen is associated with Type 1 diabetes; and wherein said compositionelicits a tolerogenic response upon administration to said subject. 10.The composition of claim 9, wherein the antigen is selected from thegroup consisting of proinsulin, immunogenic fragments thereof, andimmunogenic mimotopes thereof.
 11. The composition of claim 9, whereinthe erythrocyte-binding moiety comprises an antibody fragment, whereinthe antibody fragment is derived from a 10F7 clone, and wherein theantibody fragment has undergone affinity maturation.
 12. The compositionof claim 9, wherein the erythrocyte-binding moiety is chemicallyconjugated to the antigen.
 13. The composition of claim 9, wherein theerythrocyte-binding moiety is fused to the antigen via recombinant DNAtechnology.
 14. A composition for immunomodulation to achieveantigen-specific tolerance, the composition comprising: one or moreantigens fused or chemically conjugated with an erythrocyte-bindingmoiety; wherein said one or more antigens is selected from the groupconsisting of proinsulin and immunogenic fragments thereof, andimmunogenic mimotopes thereof; wherein said one or more antigens beingrecognizable by an immune system of a subject, the immune system of thesubject being able to respond to or previously having responded to theone or more antigens with an unwanted immune response, saiderythrocyte-binding moiety having the ability to non-covalently,specifically bind an erythrocyte surface in situ in blood and presentsaid one or more antigens to the immune system of the subject, whereinsaid erythrocyte-binding moiety comprises at least an antibody or anantibody fragment.
 15. The composition of claim 14, wherein theerythrocyte-binding moiety has the ability to bind Band 3 (CD233),glycophorin-A, glycophorin B (CD235b), glycophorin C(CD235c), orglycophorin D (CD235d) with an affinity generating a dissociationconstant of between about 10 μM and 0.1 nM as determined by equilibriumbinding measurements between the erythrocyte-binding moiety anderythrocytes.
 16. The composition of claim 14, comprising two or moreantigens selected from the group consisting of proinsulin, immunogenicfragments thereof, and immunogenic mimotopes thereof.
 17. Thecomposition of claim 16, wherein said antigens are conjugated to amultimeric branched polymer.
 18. The composition of 17, wherein theerythrocyte-binding moiety is derived from a 10F7 clone, and wherein theerythrocyte-binding moiety is affinity-matured.
 19. The composition ofclaim 14, wherein the erythrocyte-binding moiety is fused via a linker,to the N- or C-terminus of the one or more antigens.
 20. The compositionof claim 19, wherein the linker is a peptide, a polymer, an aptamer, anucleic acid, or a particle.
 21. The composition of claim 20, whereinthe polymer is synthetic, and wherein the polymer is branched.